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Ear Surgery

Otoplasty/Ear Surgery, also known as Ear Pinning, Ear Pinback, or Ear Reduction Surgery, is the cosmetic plastic surgery procedure that permanently corrects protruding ears. Otoplasty does so by positioning the ears closer to the head (Ear Pinning), reshaping them, reducing their size, and making them more symmetrical. Protruding Ear Deformity is the most prevalent congenital malformation of the head and neck area.

Ear Surgery ranks as the most commonly performed plastic surgery Procedure on children between ages five and fourteen. In fact, Ear Pinning is one cosmetic surgery where “earlier is better” because of the devastating blows to a child’s self-esteem, who is teased for having protruding ears; being called names such as “Dumbo,” “Mickey Mouse” and “Rabbit Ears”. The optimal time for performing otoplasty in children is just before they start school, or at about the age of seven. At this age the ears have grown to nearly their adult size and the child is old enough to be able to undergo surgery safely. It also gives children a chance to correct their facial deformity before starting to socialize with peers in school.

Ear Surgery/Otoplasty has also been a blessing for thousands of adults who have spent their lives feeling self-conscious about their “big ears”. They have hidden their ears with hairstyles, hats, and avoided wearing ear jewelry. With Otoplasty they have gained the freedom to wear their hair short or pulled back, wear earrings, and no longer feel embarrassed about their look. While Otoplasty aims to normalize the appearance of the ears it can never produce perfect and fully symmetrical ears. Therefore, parents who are considering Ear Pinning for their children, and adults who are considering the procedure, should have realistic expectations. After all, no two ears are ever identical or perfectly symmetrical.

How is Otoplasty Performed?

Otoplasty, the reshaping and repositioning of the external ear, is done on an outpatient basis. Performed skillfully, Otoplasty makes the ears more proportional to the size and shape of the head, as well as pinning it back closer to the head. The procedure generally takes about two hours, or one hour per ear, depending upon the degree of correction that his needed.

Otoplasty begins with an incision just behind the ear, in the natural fold where the ear is joins the head. The actual techniques involved can be categorized as either Cartilage Splitting (Cutting), or Cartilage Sparing.

Cartilage Cutting involves cutting or weakening of the antihelix, helix or cocha. At times a part of the cocha is removed in order to reduce its size, thus lessening the auricular prominence and protrusion. The primary disadvantage of this technique is that the edges of cut cartilage can be felt and even sometimes be visualized.

Cartilage Sparing, popularized by Dr. Mustarde, involves reshaping and repositioning the cartilage via multiple suspension sutures placed through the cartilage. The helix and anti-helix folds are created and the ears are literally pinned back! While this technique avoids the possibility of having visible edges of cut cartilage, it is technically more challenging.
Next, the protrusion of the lobules is addressed. The projection and the size of the lobules can both be adjusted by removing excess skin and/or prominent cartilage.

After reshaping and repositioning the ear cartilages, the excess skin folds behind the ears are removed and the wound closed with sutures.

Before

After

Special ear-protecting bandages are applied and the patient is then awakened from surgery.
It is important to note that even if only one ear needs "pinning back," surgery will probably be recommended on both ears to achieve the most symmetrical and natural appearance.

Otoplasty may also involve creating a fold in the upper ear in order to fix "shell ears" or "lop ears" in which the folds are not properly formed.