Plastic and reconstructive surgeon Dr. Stephen Lex discusses everything you need to know about otoplasty, or ear pinning surgery, including types of otoplasty, how the procedure is performed, and what to expect.
By: Stephen Lex, M.D.
The ear is a complex structure composed of cartilage and skin forming intricate folds and involutions. Ears that stick out or appear disproportionately large can attract attention and make individuals feel self-conscious. This is particularly true for children and teenagers who may experience teasing or bullying from peers.
What is Otoplasty?
Otoplasty, or external ear surgery, is an aesthetic procedure most commonly performed to correct prominent or protruding ears. By reshaping and repositioning the ears closer to the head, the procedure can create a more balanced appearance. Otoplasty helps many patients improve their self-confidence and body image, allowing them to feel more comfortable and at ease with their appearance.
Common Prominent Ear Complaints
Prominent or protruding ears can be attributed to several factors. Sometimes prominent ears are inherited from parents or other family members, as certain ear structures or cartilage formations may be genetically predisposed to contribute to ear protrusion. Ear prominence can also be influenced by the growth and development of the ears during childhood. The ears may protrude as a result of uneven or asymmetric growth during fetal development or early childhood.
Some of the most common cosmetic complaints that I hear from patients seeking otoplasty include:
- Absence or Weakness of Antihelical Fold: The antihelical fold is a natural fold in the middle part of the ear, however, in some individuals with prominent ears, this fold may be absent or underdeveloped. Without a well-defined antihelical fold, the ears can appear more prominent.
- Overdeveloped Conchal Bowl: The conchal bowl refers to the hollow, bowl-like area of the ear just outside the ear canal. In some cases, the conchal bowl may be larger or more pronounced, contributing to the appearance of protrusion.
- Excessive Cartilage: The amount or shape of the cartilage in the ear can affect its position and prominence. If the cartilage is overly developed or not properly folded, it can cause the ears to stick out.
- Protruding Angle Correction: Most people’s outer ear protrudes from the head at an angle of about 15 degrees, however, if this angle exceeds 25 degrees then the ears may look as though they’re sticking out from the side of the face. Otoplasty can draw the ears back to the head into a more natural-looking position.
It’s important to note that ear prominence doesn’t pose any health risks and is purely a cosmetic concern. However, for individuals who feel self-conscious or are subjected to teasing or bullying due to prominent ears, otoplasty can help improve their appearance and self-confidence.
Benefits of Otoplasty
Otoplasty, or ear surgery, offers several benefits to individuals who are unhappy with the appearance of their ears. Some benefits of otoplasty include:
- Corrects Protruding Ears: By reshaping and repositioning the ears closer to the head, the procedure can create a more balanced and natural appearance.
- Enhances Self-Confidence: Protruding or misshapen ears can often lead to self-consciousness and a lack of self-esteem, particularly in children. Otoplasty can help improve self-confidence and body image, allowing individuals to feel more comfortable and at ease with their appearance.
- Improves Facial Harmony: By addressing irregularities or imbalances in ear shape or size, otoplasty can enhance the overall aesthetic appeal of the face.
- Long-lasting Results: Otoplasty typically provides long-lasting results, and the improvements achieved through the procedure are generally permanent. Once the ears have healed, the changes made during surgery should remain stable and maintain their aesthetic benefits over time.
- Minimal Risks: Most patients can return to everyday activities within a few weeks, and the risks associated with the surgery are minimal.
Otoplasty Aesthetic Goals
Mere millimeters can make a significant difference when we’re striving for symmetrical and well-proportioned ears. While every patient’s anatomy is unique, there are some common surgical goals we keep in mind when evaluating otoplasty patient anatomy and making our treatment recommendations:
- Ensure that the upper third of the ear is not protruding.
- Make the helix of both ears visible beyond the antihelix when facing the patient, and ensure that the helix is smooth throughout.
- The postauricular sulcus is not distorted or too small.
- Measurements between the helix to mastoid fall within a normal range of 10 – 12 mm in the upper third, 16 – 18 mm in the middle third, and 20 – 22 mm in the lower third.
- The lateral ear border to the head should be symmetrical (within 3 mm) at any point between the ears.
Types of Otoplasty
This is the most common type of otoplasty performed to correct prominent or protruding ears. It involves reshaping the ear cartilage to create a more natural contour and position the ears closer to the head.
Antihelical Fold Correction
In some cases, the antihelical fold, which is responsible for the natural curvature of the ear, may be weak or absent, contributing to ear protrusion. Antihelical fold correction focuses on creating or enhancing this fold to achieve a more balanced ear appearance.
When the conchal bowl, the hollow area of the ear, is excessively large or prominent, conchal reduction may be performed. This procedure involves removing or reshaping the excess cartilage from the conchal bowl to reduce its size and improve ear symmetry.
Earlobe reduction is typically performed when the earlobes are disproportionately large or elongated. It involves removing a portion of the earlobe tissue to create a smaller and more aesthetically pleasing size and shape.
Reconstructive Otoplasty for Congenital Deformities
Otoplasty can be used to correct a variety of congenital ear deformities, such as lop ear, cupped ear, microtia, or shell ear. We don’t perform congenital deformity otoplasties at our practice in Flagstaff, however, there are some qualified plastic surgeons we can recommend in the Phoenix area where we refer patients with congenital ear deformities.
Reconstructive Otoplasty After Trauma or Injury
Otoplasty can also be performed for reconstructive purposes after injury or trauma to the ear. These reconstructive surgeries typically involve restoring parts of the ear using tissue grafts or implants to restore the natural appearance of the ears and improve their functionality.
What to Expect from Your Cosmetic Otoplasty Surgery
Before your ear surgery, we’ll talk to you about your surgical goals and medical history, and review your anatomy. We’ll take measurements and photographs and will make a treatment recommendation based on your unique expectations and goals. During this consultation, we’ll also answer your questions, walk you through the otoplasty procedural steps, discuss potential risks and complications, and talk about recovery and aftercare.
We perform ear surgery as an outpatient procedure at our accredited Northern Arizona SurgiCenter in Flagstaff. On the day of your surgery, you’ll be checked in by our staff, prepped for surgery, and will get to talk to your surgeon to review the surgical plan a final time. Based on our procedural approach, you may be put under general anesthesia or IV sedation by an anesthesiologist, or receive a local anesthetic. We’ll make a small, discreet incision on the back of your ear or within the inner creases of the ear. Through these small incisions, we will remove excess tissue and cartilage and secure the ear shape with internal stitches. Finally, we’ll close the incisions. The entire procedure takes about one to two hours.
Recovery after Otoplasty
You can go home after your surgery, but you will need somebody to drive you if you’ve received non-local sedation. Following surgery, we’ll wrap your ears in bandages to protect the incisions. Please be gentle with the ears and avoid touching them, which may also mean not wearing glasses or earrings for three weeks. We’ll remove the bandages in a few days, and we may provide you with a protective garment to wear over your ears at night while you sleep for the first week following surgery. It’s important to sleep on your back to avoid putting pressure on the ears for a week or so. If we use dissolvable stitches, they won’t need to be removed. We’ll take removable stitches out one week after surgery.
Scars from otoplasty surgery are usually hidden behind the ear or within the ear folds so they aren’t visible. Performing scar massage with a gentle lotion or moisturizer can help promote wound tissue remodeling and reduce the appearance of scars.
We may prescribe pain medications and an antibiotic ointment to apply to the incisions. Over-the-counter medications, such as Tylenol, can help relieve mild pain. Many patients can resume walking and light exercises right away, but need to avoid high-impact activities for two to four weeks based on how they’re healing.
Am I A Good Ear Surgery Candidate?
We generally perform otoplasties on teenage and adult patients who are healthy, nonsmokers, and who don’t have any medical conditions that may impede wound healing.
When you meet with one of our surgeons for your ear surgery consultation, we will discuss your goals and anatomy to determine which cosmetic procedures would be best suited to meet your unique needs.
How Much Does Otoplasty Cost?
Every plastic surgery practice offers different pricing. The national average procedural fee for a cosmetic otoplasty procedure is around $3,700, plus the cost of anesthesia, surgical facility costs, and medications. Some otoplasty cases performed in children to correct congenital defects are covered by insurance. However, many ear surgeries are considered cosmetic and not covered by insurance. Please set up a consultation with one of our surgeons to learn more about the procedure and to receive a personalized quote.
Book An Otoplasty Consultation Today
Our experienced, board-certified plastic surgeons have performed thousands of cosmetic and reconstructive procedures. We would love to bring you in for an otoplasty consultation to discuss your desired outcomes and treatment options.
Author Profile: Stephen Lex, M.D., is a highly experienced board-certified plastic and reconstructive surgeon and co-founder of Plastic Surgeons of Northern Arizona practice. Dr. Lex has practiced in Flagstaff since 1989 and specializes in cosmetic surgery, microsurgery, craniomaxillofacial surgery, and reconstructive procedures.