Ear correction surgery: pinnaplasty

Specialty of Otolaryngology / ENT

What is pinnaplasty?

Ear correction surgery, where the ears are pinned back, is known as pinnaplasty or otoplasty. The cosmetic surgery procedure is used to change the size or shape of the ears, or to pin them back if they stick out. It is usually carried out on children and teenagers but some adults may opt to have the procedure too. Children under the age of five are unable to have pinnaplasty as their ears are still developing and growing.

What happens during a pinnaplasty?

Pinnaplasty is performed under local or general anaesthetic, depending on the age of the patient. The operation usually takes about one to two hours. The surgeon will make a cut to the back of the ear and peel off some skin from the cartilage. The shape of the cartilage is changed so that the ear is closer to the head. The doctor can also correct the symmetry of the ears too. The wounds are then closed with stitches and a dressing is applied.

There is a newer technique known as incisionless otoplasty to treat prominent ears, which involves scoring the cartilage through the ear skin using a needle. No incision is made. There is not a lot of evidence about the long-term quality of this procedure.

What happens after pinnaplasty?

Following surgery, the ears may be sore, tender or numb for a few days and the patient may need to wear a bandage around their head. They will not be able to wash their hair for a few days whilst leaving the dressing on to protect the ears from infection. It is useful to sleep upright for a few nights following surgery.

There may be bruising for a few weeks and it is recommended taking the time off school or work to let these heal. The stitches may come to the surface and cause the ear to feel sore, which can be treated with over the counter pain medications. After 10 days the stitches are removed.

What are the possible complications of pinnaplasty?

Complications are unusual. There can be a collection of blood between the skin and the cartilage, which creates 'cauliflower ear'. On some occasions, the skin may scab and the patient must be very careful with their dressings to ensure that underlying cartilage is not exposed, dried out or infected. If it does dry out then it can cause a misshapen ear and another procedure will be needed to repair the hole with a skin graft. If the area is red, swollen or painful post-operation, this may be a sign of infection and the patient should consult their doctor.

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