What is an Otoplasty or ear pinning? Causes and Correction




Otoplasty, or ear pinning, is a general term for surgical correction of the prominent ear. Over projecting or prominent ears are significant congenital ear deformities that vary in severity and cause.

Prominent ears can unfortunately be a source of teasing for a young child, which can do psychological harm to the child’s developing self-image. Prominent ears can also be a source of repetitive trauma and irritation, especially with the on and off of helmets in athletics.

  • Diagnosis of prominent ears include the frontal view looking for one or both ears protrude out from the head more than normal with flattening of the upper ear fold and enlargement of the conchal bowl.

The prominent ear can be present at birth and can be molded at a very early age (younger than 6 weeks) with a simple soft hat or headband, or a customized mold which is taped to the scalp. After this time, the external ear develops over the first three years and after that the ear prominence can be fully evaluated.  Otoplasty can be performed on children and adults. The cartilage of a younger child is softer and more pliable than an adult’s, this may factor in to the choice and number of sutures needed for correction.

Components of the ear as it pertains to Otoplasty:

  1. Anti-Helix which includes the upper folds of the ear are typically flattened and/or absent. The lack of folding in the upper ear is a common point of correction in re-creating the natural upper ear.
  2. Concha is the bowl of the ear which can be large and cause the ear to protrude more. Reduction of the conchal bowl and/or setting the bowl back are components to the otoplasty if needed.
  3. Lobule is often under estimated and usually requires reduction after the helix and concha are reshaped.

There can be multiple components to the prominent ear, including effacement of the upper fold of the ear, enlargement of the conchal bowl, or a combination of the two. Prominence can be mistaken for cupping or constriction of the ear, which may require a different operation for correction. In order to correct the prominent ear, the cause of the prominence should be identified and usually 2 out of the 4 causes should be addressed in order to give a natural and long lasting correction. The operation can be performed at earliest at the 3rd year of age, but more commonly in between kindergarten and the first grade. Otoplasty can be performed at any point after this age. Adults are common candidates for this out-patient procedures.

The otoplasty operation usually takes under two hours and is an outpatient operation/procedure. The ear prominence is corrected through an incision in the back of the ear, which enables folding, suturing and reducing the ear prominence. The sutures are internal with minimal external scarring in the back of the ear. A simple head dressing is worn for about 7 days and then transitioned to a simple headband dressing is all that is needed. Scarring is usually minimal and the most common risk is partial recurrence of the prominence. An otoplasty consultation with photographs is an important component to planning an otoplasty, or ear pinning procedure with Dr. Trussler.

Andrew P. Trussler MD is an experienced plastic surgeon in Austin Texas with advanced training in cosmetic and reconstructive ear surgery including correction of prominent ears.

Dr. Trussler’s Austin plastic surgery office can help guide you in correcting commonly seen cosmetic ear complaints. An otoplasty is a plastic surgery procedure in Austin Texas that should be a smooth and straight forward process that will improve appearance and self confidence.

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