Pin back otoplasty

Alternative names
Cosmetic ear surgery; Otoplasty; Correction of Outer ear deformity

Definition
Cosmetic ear surgery is performed to set disproportionately large or prominent ears closer to the head.

Description

Thousands of otoplasties are performed successfully each year. The surgery may be done in the surgeon’s office-based facility, in an outpatient surgical facility, or in a hospital. It may be performed under a local anesthetic which numbs the area around the ears, or under a general anesthetic which will cause sleep through the entire operation. The procedure usually lasts about 2 hours, depending on the extent of the surgery.

The most commonly employed technique is one in which the surgeon makes incisions in the back of the ear and removes skin to expose the ear cartilage. Sutures are used to fold the cartilage to reshape the ear. The same result in some instances can be achieved without sutures by cutting or abrading the cartilage before folding it. The skin incisions are sutured closed. The ear is brought closer to the head by creating a more pronounced fold (called the antihelix) in the central portion of the ear.

Indications
The procedure can be performed on a child after the age of 4 years when ear growth is almost complete. When disfigurement is severe (lop ears), a child should have surgery early to avoid possible emotional stress when he or she enters school.

Risks
Postoperative complications such as blood clots and infection are uncommon. A second operation may become necessary if a “pin back” ear occasionally protrudes again.

Expectations after surgery
The ears are covered with a bulky, moderate pressure dressing following surgery. There is some tenderness and discomfort that is easily controlled by medication. If the surgery is done in a hospital, release is usually the same day or the day after the operation.

Convalescence
Within 2 to 4 days, the outer pressure dressings are removed but the patient is asked to wear a light head dressing for 2 to 3 weeks to promote healing. Faint scars are concealed in the flexion creases behind the ears; there are no incisions in front of the ears. The decision on when to return to school or work and normal activities depends on how fast healing occurs.

Johns Hopkins patient information

Last revised: December 7, 2012
by Mamikon Bozoyan, M.D.

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