Otoplasty(Ear Pinning) 101: What You Need to Know
Otoplasty, more commonly referred to as “ear pinning”, can be one of the most satisfying and impactful surgeries for both the surgeon and patient. Prominent ears that stick out too far or have an abnormal shape can be the cause for much distress in a young child’s life. Adults who were bothered by ear prominence in childhood but were unable to seek intervention, may choose to undergo surgery as well.
Luckily, the procedure is not one that carries great surgical risk and is not a long recovery. Adults may be able to have the procedure under local anesthetic or sedation (to make them sleepy, but not completely asleep); children most often must undergo a general anesthetic for 1-2 hours.
The procedure itself involves making an incision in the crease behind the ear-this allows the incision to be completely hidden. The surgeon will then decide where to place sutures to allow folding of the cartilage in specific locations. Sometimes, cartilage may need to be weakened or even cut, to allow the desired changes. In some cases, there is too much depth to the bowl of the ear and the whole ear protrudes from the scalp over 2 cm (not quite an inch). In those cases, sutures can be placed to pull the bowl back towards the scalp in several specific locations. Other times, there is underdevelopment of the crease at the top of the ear. Again, the surgeon will plan for the crease in a specific location and place a series of precise sutures to create the ideal fold. Many patients require both of these procedures and may have only one ear, or both that require surgery.
The most common issue after otoplasty is asymmetry between the ears. It is impossible to recreate the exact same measurements from one side to the next, but most surgeons will take careful measurements throughout the procedure and only complete the closure when the measurements are the same or within 1-2 mm of each other. The postoperative recovery period is essential for giving the ears the correct support to prevent recurrence of the protrusion until the scar tissue on the cartilage can form. Most surgeons will place a pressure-type dressing over the ears for 24-48 hours and then evaluate the patient for satisfactory healing. Dressings will be removed and a smaller, yet supportive, dressing will be worn for 1 week at all times. Any sutures will be removed at that point, and the surgeon may request the patient wear the softer dressing at night for an additional week. The natural folds and swelling will resolve over 1-2 weeks. Patients can return to work between 1-2 weeks and start strenuous activity at 2 weeks. No contact sports are allowed for 2-3 months to prevent injury to the cartilage during healing.
The one case in which surgery may not be required is in a newborn in whom the ears may be noted early to be folded incorrectly. Due to maternal hormones, the ear cartilage is extremely malleable. In the first few weeks of life, the ear can actually be molded to the more correct shape through a series of small dressings. This can prove incredibly effective to avoid future surgery if these issues are noted at or around the time of birth. Of course, many patients won’t even develop prominence until much older, at which time molding is ineffective.
Otoplasty is a surgery that requires extreme attention to detail and precision-since there is an exact duplicate immediately available for comparison! However, the procedure has been shown to increase confidence and social comfort for many children and adults. If otoplasty or “ear pinning” is something you have been considering, take the time for find a facial plastic surgeon with experience, who can answer your questions and address your concerns. Otoplasty is one of the facial surgeries with the shortest recovery time, a big impact and high satisfaction rates. Best wishes!
