Otoplasty (Ear Reshaping)

Pinnaplasty is a common procedure to pin back prominent, protruding ears. 

Common causes of sticking out ears include an underdeveloped antihelical fold, excessive cartilage in the concha or a combination of both. 

This straightforward procedure sees the surgeon make an incision (cut) at the back of the ear before removing some skin from the cartilage. This cartilage is reshaped so the ear sits closer to the head. The wound is closed with stitches and a dressing is applied to the area.

During pinnaplasty, a surgeon can also correct ears which are not evenly shaped on both sides (asymmetrical).

It is a straightforward procedure and helps to restore a patient’s self-confidence if they are self-conscious about the size, shape or prominent appearance of their ears.

Ear pinning surgery is usually completed in less than an hour.

Pinnaplasty is usually carried out on children and young teenagers, although adults can also undergo ear pinning surgery. Pinnaplasty can be performed on children as young as six years old.  This is often the ideal age to correct the ears as they have reached their adult size.

Ear pinning is not suitable for under fives as the ear cartilage is too soft to hold the stitches in place.

Ear reduction, as the name suggests, is a cosmetic procedure to reduce the size of the ears. Oversized ears, which are out of proportion with the rest of the face, can result in considerable anxiety and low self-esteem, which is why many people opt for this particular form of otoplasty.The medical term for disproportionally large ears is macrotia. 

In ear reduction surgery, the surgeon will remove excess skin and cartilage to reshape and reduce the size of the upper or lower half of the ear, or the whole ear. Ear reduction surgery can be used to reduce the height and width of the ear. Ear reduction will help make oversized ears smaller, restoring a balanced appearance to the face.

Neurofibromatosis, a genetic disorder of the nervous system, can leave ears enlarged and sitting in the wrong place on the side of the head. Some lymph tissue growths can also alter the size of the ear, resulting in the need for ear reduction.

Ear reduction surgery can also help with the problem of stretched earlobes, a common problem caused by the frequent wearing of heavy jewellery, or so-called skin tunnels, large holes in the lobes created as a form of body modification. 

Ear reduction surgery only focuses on the size of the ears. The procedure can be carried out alongside pinnaplasty if the ears are also protruding.

Ear reduction surgery delivers natural-looking results and can transform a patient’s self-confidence. This type of otoplasty can be performed on both adults and children.

Ear correction is the catch-all term used to describe surgery to correct deformities of the ear which have either been present from birth or caused by trauma.

Babies born with small or absent ears (microtia) will require ear correction surgery as the condition can affect their hearing. This can be done by using the child’s own tissue to reconstruct the ear, by placing a prosthetic framework under the skin or a prosthesis used above the skin.

Most ear-trauma injuries are caused by lacerations or biting, and such injuries require emergency treatment. The damaged ear is left to heal before reconstructive surgery is carried out. The techniques used are similar to those used to treat microtia.

‘Cauliflower ear’, caused by a pooling of blood in the outer ear, is a common ear problem which can benefit from ear correction surgery. If left untreated, the blood can become scarred and calcified, resulting in a thickened cauliflower ear. This condition is common among rugby players and boxers. A surgeon will treat a cauliflower ear by lifting the skin from the front of the ear, thinning out the thickened tissue to recreate the original shape of the ear.

A surgeon will have to carry out ear correction surgery in a case of skin cancer of the ear. This issue is dealt with by way of surgical excision and reconstruction.

Infections caused by ear piercings through the cartilage, such as a helix piercing, can cause a loss of ear structure. In some cases the surgeon may need to reconstruct the ear using cartilage taken from the ribs.

The first step for all of our otoplasty patients is to meet with the surgeon we feel is best placed to perform your procedure for a consultation. At the consultation you will be able to discuss with your surgeon what your hope to achieve from the procedure, as well as discuss in detail what may or may not be possible given your existing anatomy.

Your surgeon will take you through the options available to you, and which is the most preferential for you given your stated ambitions. Having established this, several key measurements will be made and standard clinical photography will be taken.

Some common questions to ask at your otoplasty consultation include:

• How many procedures of this type have you performed?
• Am I a good candidate for this procedure?
• What technique will you use to get the best results?
• Do you have before-and-after photos I can look at for each procedure and what are reasonable results?
• What are my options if I am dissatisfied with the outcome of my ear surgery?
• Finally a comprehensive discussion regarding risks and complications will take place, alongside a discussion regarding what to expect in the post procedure and recovery phase. Your previous medical history will also be recorded (including previous surgery, medications, allergies etc.) and an assessment of your fitness for surgery.

If your surgeon feels you are a good candidate for surgery, you are then invited to consider whether you would like to proceed for surgery or otherwise following a two week 'cooling off' period.

Within this period you are welcome to come in and discuss your potential surgery with your surgeon as many times as you like.

If you choose to proceed with surgery, the next time you come into the Clinic after your final consultation will be the day of your procedure. Before admission the following behavioural changes are recommended / required:

• In the 6 weeks before your procedure we recommend smoking is discontinued as patients who smoke have a higher risk of healing more slowly and complications 
• In the week before your procedure you must cease taking Aspirin or any medication that contains Aspirin
• In the 6 hours prior to surgery you must not consume food or any drink, other than small sips of clear fluid (e.g. still water, black coffee, black tea) which are allowed up to 2 hours before admission

On the day of your procedure we ask that you arrive for your admission an hour before the agreed start time of surgery. At this point a nurse will come and record blood pressure and other relevant vitals, you will meet with your anaesthetist and your surgeon who will make the final mark-ups.

The procedure itself typically takes place under local anaesthetic over the course of one to two hours. First you will receive some anaesthesia in the ear region, then incisions will be made in several discrete areas, typically in the folds of the ear or on the back surface behind the ear.

Your surgeon will make a cut at the back of your ear and peel off some skin from the cartilage. They will change the shape of the cartilage so your ear lies closer to your head. If your ears are not symmetrical (evenly shaped on both sides) you surgeon may correct this as well. The technique they choose to use depends on the goals specific to your ear pinning procedure. After your surgeon reshapes the cartilage, they will secure it into its new position with permanent sutures. They will then close the wound discretely with stitches and apply a tight bandage around your head to stabilise the ears in their new position.

Any scarring should be well hidden behind the ear.

You should not feel much pain during the procedure, but you may have some for a few days or weeks afterwards. You'll be given painkillers if you need them.

Following the procedure, you will recover in our ambulatory recovery rooms for between one to two hours, dependent on the scale of the procedure. You will be wearing a head bandage to aid with your recovery.

Once our specialist nursing team are happy that your initial recovery is complete and you are safe to return home, you will be allowed to leave the Clinic accompanied by a friend or member of your family.

Once home you will have access to our dedicated on-call nursing team 24 hours a day, 7 days a week. This team of specialists are dedicated to your comfort and pain control, and are there to field any questions you may have in the immediate post operative phase.

We ask that you come in and see our nursing team 1 week after surgery to ensure your incision sites have been properly reviewed. At this juncture we also recommend you meet with one of our on site aestheticians to discuss ongoing treatment to support the healing and scarring process.

We ask that you come in to see your surgeon after 4 weeks for a final check up.