Ear pinning surgery (pinnaplasty) at Newcastle upon Tyne Hospital

What is ear pinning surgery (pinnaplasty)?

Ear pinning surgery, also called otoplasty or pinnaplasty, is an operation that repositions ears that stick out, bringing them closer to your head. Your surgeon reshapes the cartilage inside your ear and holds it in its new position with stitches, giving a more natural, symmetrical look.

What conditions does ear pinning surgery treat?

Ear pinning surgery is used for:

• prominent or protruding ears, often because a fold of cartilage in the ear hasn’t formed as expected, or there’s extra cartilage in the concha (the bowl-shaped part in the centre of your ear)
• ears that are an uneven shape or asymmetrical
• ears that protrude again after an earlier ear pinning operation.

Some people have ear pinning surgery for medical reasons, such as correcting a deformity you were born with, or because your ears are causing you ongoing distress. Others choose it purely for the way it looks, to feel more confident about their appearance. Because the operation only involves the outer part of your ear, it’s very unlikely to affect your hearing.

What are the benefits of having ear pinning surgery?

Ear pinning surgery can offer:

• a more balanced, symmetrical appearance
• improved self-confidence and self-esteem
• less self-consciousness about your ears, including when tying your hair back
• permanent results once your ears have healed.

Are there different types of ear pinning surgery?

There are two main approaches your surgeon might use.

The incisionless approach

This doesn’t involve cutting the skin. Your surgeon uses a needle to make the ear cartilage more flexible, then uses stitches to hold your ear in its new shape, or to fix the cartilage to the bone behind your ear. It can be carried out under a local or general anaesthetic.

The incision approach

This is the more common method for older children and adults. Your surgeon makes a small cut behind your ear, in the natural crease where it meets your head, then reshapes the cartilage underneath, removing small pieces if needed. Your ear is then stitched into its new position, closer to your head. This approach can also correct any asymmetry between your ears.

You may see this operation called either otoplasty or pinnaplasty. Different clinics tend to use the two terms interchangeably.

What happens before ear pinning surgery?

You’ll usually start with a consultation with a plastic or cosmetic surgeon. They’ll ask about your reasons for wanting the surgery, examine your ears and face, and talk through what the operation can achieve. They may also take photographs to help plan your surgery and as a record to look back on.

At this appointment, your surgeon will review your medical history, including any medications, past surgery or health conditions, to check the operation is suitable for you. You’ll also need a pre-operative health assessment. Some clinics build in a period of time for you to think things over before you decide to go ahead.

To help your recovery and lower the risk of complications, it also helps to:

• stop smoking, ideally at least 6 weeks before and after your operation
• avoid alcohol and blood-thinning medicines such as aspirin or ibuprofen for a period beforehand, from a few days up to a week depending on your clinic’s advice
• eat well and stay reasonably active in the run-up to your operation, which can support healing
• arrange for someone to take you home afterwards, as you won’t be able to drive yourself
• plan time off work or school, and get comfortable clothing and any medicines ready at home for your recovery.

If you’re having a general anaesthetic, you’ll need to stop eating and drinking for the period set out in your admissions letter, often around 6 hours beforehand, though small sips of water are sometimes allowed up to 2 hours before.

It’s also worth checking that your surgeon is registered with the General Medical Council (GMC) and belongs to a relevant professional body, such as the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) or the British Association of Aesthetic Plastic Surgeons (BAAPS). If you’re in England, you can check whether the hospital or clinic is registered with the Care Quality Commission (CQC).

What happens during ear pinning surgery?

1. You’re given your anaesthetic, usually a local anaesthetic with a sedative for adults, or a general anaesthetic if you prefer, or for most children.
2. Your surgeon makes a small cut behind each ear, usually hidden in the natural crease where your ear meets your head.
3. They access the cartilage through this cut and reshape it, folding or removing small pieces as needed to bring your ears closer to your head, correcting any asymmetry at the same time.
4. The repositioned cartilage is held in place with permanent stitches.
5. The skin is closed with further stitches, which may dissolve on their own or need to be removed afterwards.
6. A dressing or bandage is placed around your head to protect your ears while they heal.

The operation usually takes 1–2 hours, and most people go home the same day.

What does recovery from ear pinning surgery look like?

In hospital

After your operation, you’ll rest in a recovery area while the anaesthetic wears off. It’s common to feel a little drowsy, sick or light-headed at first, but this usually passes within 24 hours. Most people go home the same day, once they’ve eaten and had something to drink, been to the toilet, and can move around comfortably, though you’ll need someone to drive you home.

At home

Your ears will be covered with dressings and a bandage around your head, which needs to stay clean and dry. You won’t be able to wash your hair until your care team removes this, usually within the first week to 10 days.

Here’s a general guide to what you can expect:

• 1–3 days: soreness, swelling and tightness around your ears. Rest with your head elevated and take pain relief if you need it
• 3–10 days: your bandage and any non-dissolvable stitches are removed, though your ears may still feel tender
• 1–2 weeks: most people return to work or school. You may be advised to wear a soft headband, especially at night, to protect your ears
• 4–6 weeks: swelling continues to settle and you can usually resume swimming and light exercise
• around 8 weeks: contact sports can usually resume, ideally still wearing a protective headband.

You may have some soreness, tingling or numbness in your ears for several weeks, along with slight bruising for around 2 weeks. A small scar behind each ear is normal and will fade with time. Discuss with your team about pain killer options to relieve discomfort. Avoid smoking, as it can slow down healing and increase your risk of infection.

Avoid driving for 24–48 hours after your operation, especially if you’ve had a general anaesthetic. You are medically and legally prohibited from driving while wearing the bulky head bandage, as it significantly impairs your hearing and blocks your peripheral vision.

Return to the road only once the bandage is completely removed, you can turn your neck fully without pain to check blind spots, and you are off all sedating painkillers.

What are the risks and complications of ear pinning surgery?

Ear pinning surgery is generally safe and most people are happy with the results. As with any operation, though, there are risks to be aware of.

Common and minor risks

• infection at the wound site, usually treated with antibiotics
• pain, bruising or swelling around your ears, which usually settles within a few weeks
• asymmetry (a small difference in the shape or position of your ears)
• temporary numbness, tingling or stiffness in your ears, with flexibility returning over time
• your ears gradually protruding again if they don’t heal as planned.

Less common risks

• a haematoma (a small blood clot under the skin of the ear), or inflammation of the ear cartilage
• excessive bleeding during or after surgery
• an allergic reaction to the anaesthetic
• a blood clot in your legs or lungs, or a chest infection, particularly after a general anaesthetic
• a hypertrophic scar (one that becomes thickened and pink) or, more rarely, a keloid scar (one that keeps growing), which is more common in people with darker skin
• necrosis (loss of tissue) at the wound site.

Your surgeon should explain how likely these risks are for you and how they’d be treated. Contact the clinic where you had your operation as soon as possible if you have severe pain or any symptoms you weren’t expecting.