Pinnaplasty
Published by Bupa's health information team, November 2009.
This factsheet is for people who are planning to have surgery to correct prominent ears, or who would like information about it. This factsheet is relevant for both adults who are having a pinnaplasty and parents of children who are having the procedure. However, for simplicity we will refer to 'you' throughout.
A pinnaplasty - also called an otoplasty - is an operation to reshape the cartilage of the ear to hold the ears back.
To meet your individual needs, your care may differ from what is described here. It's important that you discuss your pinnaplasty with your surgeon.
- About pinnaplasty
- What are the alternatives to a pinnaplasty?
- Preparing for your pinnaplasty
- What happens during a pinnaplasty
- What to expect afterwards
- Recovering from pinnaplasty
- What are the risks?
- Questions and answers
- Related topics
- Further information
- Sources
About pinnaplasty
Some people's ears stick out more than others. The ears are one of the first parts of the body to reach full size, at about five to six years, which is why prominent ears can sometimes be more noticeable in children. This doesn't cause any physical problems but it can make people feel self-conscious.
A pinnaplasty can pin back prominent ears closer to the head or reduce the size of large ears. The procedure isn't recommended for children under five years because until then, the cartilage that gives the ears their shape is very floppy and doesn't hold the new shape well.
It's important not to rush into the decision to have cosmetic surgery. If you're concerned about your child, wait until he or she recognises it and talk about the problem together. Discuss your options with your GP. He or she may be able to recommend a surgeon or give advice about how to choose where to be treated.
Before going ahead with pinnaplasty, discuss with your surgeon what you hope to gain from the operation and the result you can realistically expect.
What are the alternatives to a pinnaplasty?
A pinnaplasty is the only way to permanently pin back ears in adults.
In babies younger than six months it may be possible to flatten the ears using special splints or ear moulds. These help reshape the cartilage while it's still soft. If you're concerned about your baby's ears, ask your doctor or midwife for advice.
Preparing for your pinnaplasty
Your surgeon will explain how to prepare for your operation. For example, if you smoke you may be asked to stop, as smoking increases your risk of getting a chest or wound infection, which can slow your recovery.
The operation is usually done as a day case. This means you have the operation and go home the same day. It can be done under general anaesthesia - this means you will be asleep during the operation. Alternatively, you may prefer to have the surgery under local anaesthesia - this blocks all pain from your ears and the area around them but you will stay awake during the operation. You may also have a sedative to relieve anxiety and help you relax.
Your surgeon will advise which type of anaesthesia is most suitable for you.
If you're having a general anaesthetic, you will be asked to follow fasting instructions. Typically you must not eat or drink for about six hours before a general anaesthetic. However, some anaesthetists allow occasional sips of water until two hours beforehand.
At the hospital your nurse may check your heart rate and blood pressure, and test your urine.
Your surgeon will usually ask you to sign a consent form. This confirms that you understand the risks, benefits and possible alternatives to the procedure and have given your permission for it to go ahead.
Your surgeon will examine your ears and measure their shape and size. He or she may take photographs so that the results of surgery can be compared with your original appearance.
Your nurse will prepare you for theatre. You may be asked to wear compression stockings to help prevent blood clots forming in the veins in your legs.
What happens during a pinnaplasty
There are a variety of operations that can be done to correct the position of your ears. Your surgeon will discuss with you which is most suitable for you. The following is a description of the most common procedures.
Your surgeon will make a small cut behind each ear, close to the groove between your ear and the side of your head, to expose the cartilage. The cartilage will be reshaped to allow your ears to lie closer to the side of your head. Some cartilage may be removed and stitches may be used to help maintain the new shape.
Alternatively, your surgeon may make a small cut behind the ear to expose the cartilage and remove some skin. The cartilage is folded back on itself and stitches are used to hold the ear in position. The operation takes about an hour.
Usually you will need to wear a bandage around your head to cover both ears. This will protect your ears and hold them in their new position while they heal. You will probably need to wear this for about a week.
What to expect afterwards
You will need to rest until the effects of the anaesthetic have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off.
You will usually be able to go home when you feel ready. If you have had a general anaesthetic, you will need to arrange for someone to drive you home. Ask a friend or relative to stay with you for the first 24 hours.
Before you go home your nurse will give you some advice about caring for your ears. You may be given a date for a follow-up appointment.
Non-dissolvable stitches are removed seven to 10 days after surgery. If you have had dissolvable stitches, the time they take to disappear will vary depending on what type you have. They usually disappear in around two to three weeks, but may take longer.
Recovering from pinnaplasty
If you need them, you can take over-the-counter painkillers such as paracetamol. Don't give aspirin to children under the age of 16. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.
Your surgeon will talk to you about how to look after your ears after the operation and it's important to follow his or her advice. You may need to wear your bandage for up to 10 days. This will help your ears settle into their new position. Your ears may itch as they heal but it's important not to reach under the bandage to scratch as this can cause an infection or delay healing. You must keep your bandage dry - wear a shower cap when you're in the bath or shower. You can wash your hair after the dressing and stitches have been removed.
It's possible that you will have to wear a smaller, lighter headband for a few weeks after the main bandage is removed. You may need to wear this all the time or only at night to stop your ears being bent forward against the pillow.
You can usually return to work once the main bandage is removed. It's best to wait at least two weeks before going swimming and eight weeks before playing any contact sports.
What are the risks?
Pinnaplasty is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications.
Side-effects
Side-effects are the unwanted but mostly temporary effects you may get after having the procedure. Common side-effects of pinnaplasty include:
- soreness, swelling and bruising around your ears - this can last for several weeks
- numbness around your ears - this usually settles within a few weeks
- scarring - pinnaplasty usually leaves a scar on the back of your ear but this will fade with time
Sometimes the dressing can rub against your ears and break the skin. This will mean it takes longer to heal.
Complications
Complications are when problems occur during or after the operation. The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding or infection.
Specific complications of pinnaplasty are uncommon but can include:
- infection - you may need antibiotic treatment or, rarely, further surgery to drain the infected area
- bleeding under your skin (haematoma) - you may require surgery to stop the bleeding and drain the area
- unusually red or lumpy scars
- uneven appearance - your ears may not look identical
Ear cartilage is very elastic so your ears are likely to move forward a bit after the operation.
There is a small risk that the repair may not hold properly, and occasionally you may need further adjustment surgery.
The exact risks are specific to you and differ for every person, so we haven't included statistics here. Ask your surgeon to explain how these risks apply to you.
Related topics
Further information
British Association of Aesthetic Plastic Surgeons
020 7405 2234
www.baaps.org.uk
British Association of Plastic Reconstructive and Aesthetic Surgeons
020 7831 5161
www.bapras.org.uk
Sources
- Ear surgery (or otoplasty/pinnaplasty). Department of Health. www.dh.gov.uk, accessed 18 May 2009
- Prominent ears. British Association of Plastic Reconstructive and Aesthetic Surgeons. www.bapras.org.uk, accessed 18 May 2009
- Ear surgery (otoplasty). American Society of Plastic Surgeons. www.plasticsurgery.org, accessed 18 May 2009
- Setting back prominent ears. British Association of Aesthetic Plastic Surgeons. www.baaps.org.uk, accessed 18 May 2009
- Setting back of prominent ears (pinnaplasty or otoplasty). British Association of Oral and Maxillofacial Surgeons. www.baoms.org.uk, accessed 18 May 2009
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: November 2009
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