Ear Pinning or Ear Reconstruction

Otoplasty is an operation performed to ‘pin back’ protuberant or bat ears. It may be performed in childhood, frequently just prior to starting school, or in adults.

Prominent ears may be due to either an insufficient antihelical fold (see picture), an excessively deep concha, or both. Depending on the particular problem either an antihelical fold will be created or the concha will be set back and made more shallow. Frequently both conchal setback and antihelical fold creation are done concurrently.

We feel that it is very important to let the child voice his or her opinion on whether or not their ear size is troubling them. Classically, the surgery has been done when the child is between ages 6 to 7 years old. However, more recently, this timetable has been moved up to age 4, to avoid issues with peers as the child enters school age.

In recent years, we have seen a large number of adults who have elected to have surgery. The goal is to achieve a more balanced and natural look. However, complete and perfect symmetry is not possible as there are inherent differences within ear tissues. Most patients are very pleased with the results and improved appearance.

  • Avoid smoking prior to surgery in order to prevent unnecessary complications.
  • Also avoid Vitamin E in large doses, Arnica tablets, analgesics like aspirin and even some anti-inflammatory drugs should also not be taken prior to surgery as they can promote bleeding during the process.
  • The surgeon however will give you personal advice in this department.

Surgery begins with an incision just behind the ear, in the natural fold where the ear is joined to the head. The surgeon will then remove the necessary amounts of cartilage and skin required to achieve the right effect. In some cases, the surgeon will trim the cartilage, shaping it into a more desirable form and then pin the cartilage back with permanent sutures to secure the cartilage.

In other instances, the surgeon will not remove any cartilage at all, using stitches to hold the cartilage permanently in place. After sculpting the cartilage to the desired shape, the surgeon will apply sutures to anchor the ear until healing occurs to hold the ear in the desired position.

AnesthesiaYoung children: usually general. Older children or adults: general or local, with sedation.
Surgery Length1-2 hours or more.
Side EffectsTemporary throbbing, aching, swelling, redness, numbness.
Recovery PeriodBack to work or school: 5 to 7 days.(Strenuous activity, contact sports: 1 to 2 months.)
Stay in Hospital1 day (For General)
Stay in Thailand10 days

Pain connected with the surgery is minimal to moderate and is controlled with oral medication. Bandages are removed within a few days but may be replaced with a lighter head dressing. Wearing a tennis headband for a period of time to hold back the ears may also be recommended. Bruising around the area occurs but fades within a few weeks. Some temporary swelling occurs but this condition can be alleviated by keeping the head elevated when reclining. You may be advised to sleep on a soft pillow but not directly on the ears. Six to eight days after surgery, you may be allowed to shampoo your hair. Scars from the incisions fade significantly in time and are, for the most part, inconspicuous because the incisions are made within the creases of the ears.

POSITION: Elevate your head to decrease the swelling. Do not lie on your sides for 7-10 days after surgery. Sleep on a soft pillow or a foam pillow. If you wear glasses, modify the temple pieces of the glasses to avoid putting pressure on your ears.

DRESSINGS: Do not remove the dressings. Your surgeon or a nurse will do this 3-5 days after surgery. Once the dressings are removed, avoid pulling on the stitches or bending the ear forward.

ACTIVITIES: Wear a headband over the ears for 6-8 weeks after surgery when sleeping or during sports activities and whenever possible. The greater amount of time you wear the headband may ensure a better result. 

OINTMENT: If there is crusting along the suture lines behind the ears, apply antibiotic ointment (terramucm or Bacitracin) after cleansing with soap and water.

COLD WEATHER: Protect your ears from cold temperatures. Because of temporary numbness, you may not feel extremes of temperatures. Tingling, burning, and “shooting pain” sensations may occur as the superficial nerves regenerate. 

WARM WEATHER: For 3-6 months after your surgery, your ears will turn pink and may swell in hot weather.