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Pinnaplasty in childrenPublished by BUPA's health information team, healthinfo@bupa.com, December 2007. This factsheet is for parents of children who are having surgery to correct prominent ears. This operation involves reshaping the cartilage in the ear and/or using stitches to hold the ears back. There is a separate factsheet available for adults considering having surgery to correct prominent ears - Pinnaplasty in adults. Your child's care will be adapted to meet his or her individual needs and may differ from what is described here. So it's important that you follow the surgeon's advice.
About pinnaplastyEars are one of the first parts of the body to reach full size, at about five to six years, which is why protruding ears can be more noticeable in children. Ears that stick out do not cause any physical problems but can make children feel self-conscious. Pinnaplasty is the only way to permanently pin back ears. The procedure is not recommended for children under five years. Because until then the cartilage which gives ears their shape is very floppy and does not hold the new shape well. It's important to talk to your child and wait until your child recognises the problem and wants his or her ears corrected. What are the alternatives?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 are concerned about your baby's ears ask your doctor or midwife for advice, and about referral to a specialist when necessary. Preparing for your child's operationPinnaplasty is usually done as a day-case, but sometimes your child may need to stay in hospital overnight. The procedure is usually done under general anaesthesia. This means your child will be asleep during the operation. Older children (teenagers) may prefer to have the surgery under local anaesthesia, in which case the ears and area around the ears is numb but they stay awake. A sedative may be given with a local anaesthetic to help your child relax. Typically your child must not eat or drink for about six hours before a general anaesthetic. The operation is often planned for the morning so that your child will only have to miss breakfast. At the hospital a nurse will ask you questions about your child's general health. The nurse will also check that your child has not had anything to eat or drink and measure your child's heart rate and blood pressure. You must tell the nurse if your child has ever had any allergic or unusual reactions to medicines. The surgeon will usually visit your child before the operation and explain the procedure. This is a good time to ask any unanswered questions. If you and your child are happy for the operation to proceed, a consent form must be signed. This confirms that you understand the risks, benefits and possible alternatives to the procedure and have given your permission for it to go ahead. If you have parental responsibility for the child, you will be asked to sign the consent form. People with parental responsibility are usually, but not invariably, the child's birth parents. Your child may wish to sign this form too. In some circumstances a child can sign their own consent form independently, providing he or she understands what they are being asked to do. The surgeon will examine your child's ears and measure their shape and size. The surgeon may take photographs, so that the results of surgery can be compared with your child's original appearance. About the operationThe operation usually takes one hour. The surgeon will make small cuts behind each ear to expose the cartilage. The cartilage is reshaped to allow the ears to lie closer to the side of the head. Some cartilage may be removed to make this easier. The ears are stitched back to hold them in their new position. Alternatively the surgeon may make small cuts behind each ear to expose the cartilage and remove some skin. The cartilage is folded back on itself and stitches are used to hold the ears in position. A bandage is wrapped around the head and over both ears. This protects the ears and holds them in their new position while they heal. What to expect afterwardsYour child will be monitored for a short while and will need to rest until the effects of the anaesthetic have passed. Your child will be groggy, and may feel or be sick. The nurse will give you advice about caring for your child's ears before you take your child home. You may also be given a date for a follow-up appointment. Dissolvable stitches will disappear on their own in seven to ten days. Non-dissolvable stitches are removed a week after surgery. Recovering from pinnaplastyFollow the surgeon's advice about pain relief. You can give your child over-the-counter painkillers such as paracetamol or ibuprofen syrup (for example Calpol or Calprofen). Follow the instructions in the patient information leaflet that comes with the medicine and ask your pharmacist for advice. Do not give aspirin to children under 16. Keep your child's head propped up on pillows. This will help reduce swelling and bruising. The bandage may need to be worn for up to two weeks to help the ears settle in to their new position. Your child may complain of itching but it's important that you stop your child from reaching under the bandage to scratch, as this can cause infection or poor healing. Keep the bandage dry. Get your child to wear a shower cap when showering or bathing. Your child may need to wear a smaller and lighter headband for a few weeks after the bandage is removed. The headband may need to be worn day and night, or only at night to stop the ears being bent forward against the pillow. Children usually need about a week off school. It's best to wait at least four weeks before taking your child swimming. 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 of this procedure. Side-effectsThese are the unwanted, but mostly temporary effects of a successful procedure, for example feeling sick as a result of the general anaesthetic. Side-effects of pinnaplasty include:
Sometimes the dressing can chafe the ears and break the skin which can take longer to heal. ComplicationsThis is when problems occur during or after the operation. Most children are not affected. The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding, or developing a blood clot, usually in a vein in the leg (deep vein thrombosis, DVT). Specific complications of pinnaplasty are uncommon, but can include:
Results of pinnaplasty may not last forever. The ears may spring back into their original position, but this is rare. It's possible that your child may not be completely satisfied with his or her appearance after the operation. The exact risks are specific to you and differ for every person, so we have not included statistics here. Ask your surgeon to explain how these risks apply to you. Further information
Sources
Related topicsThis information was published by BUPA's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by cosmetic surgeon Anthony Attwood, MB BS, FRCS (Ed.) and 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: December 2007. Expected review date: December 2009.
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