Prominent Ears Correction (Otoplasty; Pinnaplasty)
Prominent ears commonly cause self-consciousness and teasing in children and adults. Surgical correction called otoplasty or pinnaplasty has incredible psychological benefits and in vast majority of cases, it predictably leads to great improvement to the delight of patients and surgeons alike. Pinnaplasty does not reduce the size of the ear, but it recreates cartilage folds and restrains ear projection by repositioning it closer to the side of head. Pictures on the right illustrate what can be, rather consistently, achieved with surgery.
Otoplasty is carried out on a day care basis usually under general anaesthetic, but in some cases (usually adults) it is possible to perform it under local anaesthetic too. A cut is made at the back of the ear, within the ear-head crease so the scar will be hidden well and usually hardly noticeable even after only few weeks after surgery (as shown in picture 4)..
No two ears are the same, nor are individual deformities, so each operation is unique in its own right. Technical modifications are necessary and common. However, two particular surgical steps are commonly required in most pinnaplasties: 1) the cartilage and deep tissues are manipulated and reshaped using deep sutures to either reinforce or diminish its folds pending exact deformity and 2) the whole ear framework is pinned back, closer to the side of the head. Stitches (combination of non-absorbable and dissolving ones) and scar tissue which forms will ensure that repositioning and remodelling of cartilage stays permanent. It is important to ensure that new position is maintained and healing supported with disciplined recovery and gentle external support in the immediate postoperative period.
You will wake up with a head (turban like) bandage on. You should be quite comfortable as the local anaesthetic will be used to numb the ears. Some (not excessive) discomfort and a feeling of tightness is to be expected, but this is easily relieved with simple painkillers, e.g. Paracetamol or Neurofen. The bandage should be left in place until you come back to the clinic in 7 days. If it is unduly tight and uncomfortable or it gets accidently pulled and misplaced, you should call the hospital where you were operated and arrange to be reviewed earlier. Any discomfort with the ‘turban’ should be addressed early. It is important to check that ears have not been pulled awkwardly with the bandage. It is not uncommon to replace the bandage with the new one or remove it altogether few days later if it is causing more trouble then comfort.
After a week you should use a headband/hairband/scarf at night for 6 week to prevent damage to the ears whilst sleeping. Bands should not be too tight – just comfortably supporting the ears. Although the ears initially appear sore, bruising and swelling settle down very quickly. You will be asked to sit up, sleep on high pillows and avoid leaning downwards in order to avoid increase of the blood pressure in the head. You will find it difficult to wash your hair without getting the bandage wet so it is better not to try and wash it until the bandage has been removed. Try to wash your hair just before the surgery.
Potential risks and complications
Complications are rare, but as with any surgical procedure, there are general and procedure-specific risks which patients should be aware of:
- adverse reaction to the general anaesthetic
- bruising and swelling in the operated area
- Skin/wound infection
- Delayed healing
- Numbness, alteration in sensation
- Hypertrophic (lumpy and itchy) scarring
- Bleeding and haematoma formation (rarely requiring return to theatre)
- Cartilage irregularities
- Over correction or under correction
- Relapse of the deformity (this is rare if several sutures are used)
- Mild asymmetry
- Secondary procedures
- Try to wash your hair just before the surgery.
- Anticoagulation medication (Aspirin, Brufen, Warfarin, Clopidrogel) should ideally be stopped few days before the operation to reduce the risk of bleeding, but advise from the clinician who prescribed them is wise beforehand. I would strongly advise you to stop smoking prior to surgery as this can badly affect the outcome of surgery and increase complication rates.
- Please make sure that you arrange to be collected from the hospital as you will not be able to drive after the surgery.
- Plan your time off school / work / sports.
- Allow at least few weeks after surgery before considering a holiday.
I am keen to show patients schematic illustrations about the pinnaplasty as I like to engage my patients with planning of their forthcoming surgery, and help them gain basic understanding on what and how things will be done and where possible risks lie. During the consultation, I can show you the pictures on pre and post operative results achieved in some of my patients if this would be of interest to you.
This leaflet provides only basic and generic information. Full details and explanations are provided at the consultation as no two patients are the same and personal circumstances are highly individual. Patients will be provided with detailed leaflet, comprehensive informed consent on risks and complications associated with this operation, few of which are mentioned above.
If you have any concerns following your surgery please contact:
- Hospital where you were operated:
Ashtead 01372 221 442; St Anthony’s 020 8337 6691; Parkside 020 8971 8000
- Your GP practice
- My secretary on 0845 026 7776 (Monday – Friday, 9:30 – 18:00)
scar at 3 weeks
|Hospital stay||Day care|
|Anaesthetic||General or Local|
|Surgery time||1.5-2 hours|
|Wound healing||7-10 days|
|Shower / Bath||from week 1|
|Time off work||1-2 weeks|
|Sports and exercise||from week 3|
|Full recovery||3-4 weeks|