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Pinnaplasty

Published by Bupa's Health Information Team, November 2011.

This factsheet is for people who are having a pinnaplasty, or who would like information about it. This factsheet is also relevant to 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.

You will meet the surgeon carrying out your procedure to discuss your care. It may differ from what is described here as it will be designed to meet your individual needs.

About pinnaplasty

A pinnaplasty can pin back your ears closer to your head or reduce the size of large ears.

The procedure isn't recommended for children under five because, until then, the cartilage that gives the ears their shape is very floppy and doesn't hold the new shape well.

Getting advice about pinnaplasty

It's important not to rush into the decision to have cosmetic surgery. It is vital that you understand exactly what the operation involves and that it is what you want. If you're concerned about your child, wait until he or she can talk about the problem with you. Many surgeons won’t operate on children if the child is unconcerned about their ears. Discuss what options are open to you or your child with your GP.

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 of a pinnaplasty?

Pinnaplasty is the only way to permanently pin back ears in adults and children.

In babies younger than six months it may be possible to flatten their 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 and 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. It can also be done under local anaesthesia – this completely blocks pain from your ear area and you will stay awake during the operation. Your surgeon will discuss with you which type of anaesthesia is most suitable for you.

If you're having a general anaesthetic, you will be asked to follow fasting instructions. This means not eating or drinking, typically for about six hours beforehand. However, it’s important to follow your anaesthetist’s or surgeon’s advice.

Your surgeon will discuss with you what will happen before, during and after your procedure, and how any pain can be controlled. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed, so you can give your consent for the procedure to go ahead, which you may be asked to do by signing a consent form.

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.

What happens during a pinnaplasty

There are a variety of operations to correct the position of the ears. Your surgeon will discuss with you which is most suitable for you.

The operation usually takes one to two hours.

The most common procedure is for your surgeon to make a cut on the back of each ear to remove a small area of skin close to the groove between your ear and the side of your head to expose the cartilage. Your surgeon will then reshape the cartilage to allow your ears to lie closer to the side of your head.

Other techniques may involve removing a small amount of cartilage or reshaping the cartilage by lightly cutting into it. Stitches may be used to help maintain the new shape.

Alternatively, stitches can be used to reshape the cartilage without cutting into it. This is most often used in children with softer cartilage.

Once your operation is finished, your wound will be stitched up and a dressing applied.

You may 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. Your surgeon will advise you how long you need to keep your bandage on for.

What to expect afterwards

You will need to rest until the effects of the general anaesthetic have passed. A long acting local anaesthetic may be given to you before your operation. As a result, it may take several hours before the feeling comes back into your ears. Take special care not to bump or knock the area. 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.

Whether you have had a general or local anaesthetic, you will need to arrange for someone to take you home. Try to have a friend or relative stay with you for the first 24 hours.

Before you go home your nurse will give you advice about caring for your ears. You may be given a date for a follow-up appointment.

General anaesthesia temporarily affects your co-ordination and reasoning skills, so you must not drive, drink alcohol, operate machinery or sign legal documents for 24 hours afterwards. If you're in any doubt about driving, contact your motor insurer so that you're aware of their recommendations, and always follow your surgeon’s advice. You will be advised not to drive while you have a head bandage on.

Non-dissolvable skin stitches will be removed seven to 10 days after surgery. The amount of time your dissolvable stitches will take to disappear depends on the type of stitches you have. Your surgeon will advise you on the type of stitches used and how you should look after them.

Recovering from pinnaplasty

It usually takes about six weeks to make a full recovery from pinnaplasty, but this varies between individuals, so it's important to follow your surgeon's advice.

Usually your surgeon will give you painkillers for you to take home. If not, you can take over-the-counter painkillers such as paracetamol. Don't take aspirin or ibuprofen as it can cause bleeding. Always read the patient information that comes with the 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. You may need to wear your bandage for up to a week. 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 for another week or so and then at night for a month to stop your ears being bent forward against your pillow.

You can usually return to work, or children to school, after about a week once the main bandage and stitches have been removed. After six weeks you should be able to return to all normal activities (including playing any contact sports and swimming).

What are the risks?

As with every procedure, there are some risks associated with pinnaplasty. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your surgeon to explain how these risks apply to you. 

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
  • numbness around your ears – this usually settles within a few weeks
  • scarring on the back of your ear, but this should fade with time

The dressing may rub against your ears and break the skin, and if that happens it will take 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 or excessive bleeding.

Specific complications of pinnaplasty are uncommon, but can include:

  • infection – you may need antibiotic treatment
  • bleeding under your skin (haematoma) – this may require surgery to stop the bleeding and drain the area
  • unusually red or lumpy scars
  • uneven appearance – your ears may not look identical and you may need further surgery to correct this

There is a small risk that the repair may not hold properly, and occasionally you may need further adjustment surgery.

 

For answers to frequently asked questions on this topic, see Common questions.

For sources and links to further information, see Resources.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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  • Publication date: November 2011

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