Ear pinned back surgery (Pinnaplasty or Otoplasty) for protruding ears

Ear pinning is a cosmetic surgical procedure to improve the appearance of ears that stick out. It is also known as pinnaplasty, ear setback, or as otoplasty, although the latter is a general term that refers to any surgical procedure that changes the shape or the position of the ears, not just for cosmetic reasons but also for reconstructive purposes.

Protruding ears, also called prominent ears as well as with many other names, are ears of normal size that stick out far from the sides of the face; unlike other facial features, the unbalance created by protruding ears easily catches the attention and is often cause of teasing and bullying in children. For this reason, the ear pinning surgery is commonly performed on young children around age 6 when the ear is already 85% of its adult size, but there’s still demand for this surgery also in the adult population.

Protruding ears are an autosomal dominant trait and are present in about 5% of the population.

cosmetic surgical otoplasty to pin ears back when having protruding ears
Woman photo created by evening_tao – www.freepik.com

Surgical correction of ear sticking out

Otoplasty for ears of normal size that stick out is preferably performed under sedation or general anesthesia when the patient is a child or teenager, but it can be performed also with local anesthesia which is the usual choice in adults.

There are several different techniques available for ear pinning and the choice of the surgical approach will depend on the patient’s age (younger patients have softer cartilage, while adults have stiffer cartilage) patient’s anatomy and expectations and on the surgeon’s experience. The general approach is to make a half moon or spindle-shaped incision in the back of the ear removing the skin and subcutaneous tissue and exposing the cartilage which is then sutured with resorbable stitches to correct the protrusion; in some cases, it may be indicated to excise part of the cartilage as well or an anterior incision may be needed too, but it will be hidden in the inner folds of the ear. The whole procedure generally takes less than 2 hours. The results are immediate and permanent, although there may be some minor changes over a few weeks due to swelling.

Ear pinning surgery is not recommended in children younger than 4-5 as their ears are still in a development and growth stage.

Risks of otoplasty

The otoplasty for prominent ears is not a risky procedure, but as any other medical or surgical therapy there are always risks. Hematoma, scarring and infection are the main risks, chondritis (inflammation of the cartilage) is very rare but possible. There is also risk of undercorrection or overcorrection resulting in ears still prominent or too flat against the head after surgery; lastly there is the risk of asymmetry between the two ears.

Changes in skin sensation of the ear are normal due to damage to the sensory nerves, but they resolve over time.

Most patients are satisfied and pleased with the outcome after undergoing this surgery.

Recovery from ear pinning surgery

The surgeon may prescribe antibiotics and pain medications. A dressing is left postoperatively for up to a week. After the removal of the dressing, it is advised to wear a sport headband for a couple of weeks during nighttime only. Physical activity and sleeping on the side should be avoided for a few weeks after surgery.

Non-surgical ear pinning

It is possible to modify the shape and position of the ears without surgery by using splints, bandages or tapes; unfortunately, this is possible only during the first weeks of life in newborns when the cartilage is still elastic, soft and malleable.

Another technique, offered in some private practices, is the incisionless otoplasty: it consists of placing stitches to pin back the ears without making any incision and without removing any tissue. It is minimally invasive, has short operative time, low rate of complications and fast recovery. Not every patient is a good candidate for this technique.

Cost of otoplasty

Price for ear pinning surgery (otoplasty) varies depending on the geographical location, surgical technique, and chosen clinic and surgeon.

In the USA, price for otoplasty for both ears is around 4,000 to 8,000 USD.

In the UK, ear pinning surgery starts at around 2,500-3,500 GBP (3,400-4,800 USD)

In Australia the pinnaplasty costs around 5,000-8,000 AUD (3,800-6,100 USD)

In Thailand, price for ear pinning surgery for both ears is about 50,000-90,000 THB (1,600-2,850 USD)


Sources
  • The Incisionless Otoplasty Technique.
    A Gantous – JAMA Facial Plastic Surgery, Sep 2018
    DOI: https://doi.org/10.1001/jamafacial.2018.0670
  • Essentials of Aesthetic Surgery
    JE Janis – Thieme, 2018
    ISBN 978-1-62623-867-1
  • Plastic Surgery, 4th Edition, Vol 2
    JP Rubin – Elsevier, 2018
    ISBN: 978-0-323-35702-9
  • International Textbook of Aesthetic Surgery
    N Scuderi – Springer, 2016
    ISBN 978-3-662-46599-8
    DOI: https://doi.org/10.1007/978-3-662-46599-8
  • The Art of Aesthetic Surgery – Principles and Techniques, 2nd edition
    F Nahai – CRC Press, 2010
    ISBN: 978-1-4822-4166-2

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