What is ear pinning and what does it do?

The word otoplasty comes from oto – a prefix meaning ear – and plasty – a suffix meaning to shape or form. While there are many procedures that will reshape the ear for a variety of deformities, otoplasties concentrate on treating protrusion of the ear. This procedure is also commonly called "ear pinning," as it appears that one wishes to "pin their ears back" into the proper position.

Typically, the normal ear protrudes about 15 degrees or 1.5 cm from the side of the head. The helical rim, which refers to the outermost structure that goes from where the ear meets the head around to the earlobe, should be seen from the front.

An exception to this is the antihelical fold, which may protrude a little so that one does not see the entire helical rim all the way around. This occurs naturally.

What causes ear protrusion, and how is it treated?

There are usually three entities that contribute to ear protrusion.

1. There is a lack of a good antihelical fold. Surgeons may notice the antihelical fold will often look like a crisp "Y" in the normal year. It is usually less well-formed in the protruding ear. Sutures are then placed to create this "Y," reshape the ear and move it towards the side of the head.
2. Your conchal cup – formed in the ear by the cartilage around the auditory canal – is too deep. If you turn your head sideways in the shower, the conchal cup is what fills up. Often, the rim of the conchal cup will be resected to make the walls of the cup shallower, which can reduce protrusion of the ear.
3. The distance between the concha and the side of the head is too great. This is usually a smaller point, but moving the concha towards the side of the head with sutures can sometimes be useful.

In your consultation with a plastic surgeon, the surgeon will typically take a medical history and do a physical exam. The surgeon will then ask about health issues that can affect the outcome and what can reasonably be expected. If your surgeon believes you are a good candidate, they will proceed with providing an otoplasty procedure.

One of the nice things about this procedure is that, typically, the incision line is placed on the backside of the ear, so the incision line is not easily seen. However, different plastic surgeons will make other small incisions in some cases, depending on that particular case or technique.

Usually, the procedure results will last for a very long time. Because it is said that cartilage has "memory" – it wants to spring back into its original position – in some cases, the ear may swing out just a bit. In this case, surgical correction is done.

Most patients return to work or school in about a week. We usually will have the patient wear a compression-type bandage and/or headband for a few weeks, especially at night.

When should you get an ear pinning procedure?

If possible, the surgeon would want the ear to be large enough to make it more straightforward to work on. Surgeons also try to intervene before school age so that the child does not have to be teased.

A standard time period for otoplasties is usually between the ages of five and eight. Having said that, surgeons often treat teenage patients if, for some reason, surgery was not an option at a younger age. While younger is typically best, more and more older patients are also coming in to get their ears addressed.

A life-changing procedure

We have found that this is one of those procedures that can really make a difference. There is often this "Hollywood moment" where the patient is given a mirror. The bandages are removed. The patient starts crying, and the mother starts crying... it can be quite impactful.

For more information, please see a board-certified plastic surgeon. They will be able to answer any questions you may have about the procedure.