Otoplasty, commonly known as ear pinning,  is performed to reduce overly prominent ears. Richmond area facial plastic surgeon, Dr. Matthew Bridges M.D. FACS, helps patients as young as 4-6 years old by surgically modifying ears that are over-sized, stick out, or have developed in an abnormal shape.  While the typical otoplasty patient is a young child, otoplasty can be performed at any age.  For adults, the surgery can be performed under local anesthesia in the clinic.

The technique used during otoplasty will depend on the abnormality. The incision is generally placed along the natural crease behind the ear, which is nearly invisible after healing.  The most common issue with protruding ears is the under-formation of the antihelical fold.  This is the main fold of the upper part of the ear.  The surgical goal can be simulated by folding this part of the ear back.  The fold is typically created or enhanced surgically be placing permanent sutures that pull the cartilage together across the fold.  Further stitches can be placed to bring the entire ear closer to the head as well.  Great care is taken to make the two sides as symmetric as possible. 

Otoplasties in children are performed in the operating room under general anesthesia.  Adults can have the procedure under local anesthesia in the office. The entire surgery typically takes about 2 hours to complete and is done as an outpatient. After surgery, patients will be sent home with their heads wrapped in a bandage, which will be removed and replaced the next day in the office.  A removable headband is worn around the clock as much as possible for the next week, then at night only for several more weeks. Younger patients will need to be monitored so they do not touch or play with their ears during the healing process. 

The results following an otoplasty procedure are long lasting. However, just like any other cosmetic procedure, aging and gravity may cause increased laxity. This could eventually affect the position of the ears. For the most part, the improvements made with this surgery are considered permanent.

Children between the ages of 4-6 are considered within the ideal range for this surgery. From an anatomical standpoint, believe it or not, the ears have reached nearly adult size around this age. From a psychological standpoint, having this surgery before starting elementary school can help avoid teasing and ridicule from classmates. Some studies have shown that performing this surgery younger than age 6 can still result in excellent results.

In the majority of cases, both ears are affected. Therefore, surgery is performed on both ears. However, sometimes only one ear is prominent and asymmetric to the other side.  If this is the case, surgery will be performed on the affected ear, which will be made to match the opposing ear.