Around 1%-2% of the UK population consider their ears
to be too prominent. In many cases the shape and lie of the ears is inherited,
and a family trend can be seen. The most prominent ears often lack a normal
fold, and sometimes one ear is more prominent. People with prominent ears
are sometimes teased, particularly during their school years, and this
can lead to a loss of self-confidence.
When an ear is noted to be prominent within the first
few weeks of life, it is possible to reshape it by applying a small splint
to the rim. The cartilage or gristle of a new-born's ear is very floppy
and easily remoulded, and after several weeks of splintage a permanent
correction can be achieved. The older the child, the more stiff the cartilage
and the longer the period of splintage must be. By the age of six months
the cartilage is too hard to be remoulded and a surgical solution is required.
Otoplasty (Pinnaplasty) is an operation that adjusts
the shape of the cartilage within the ear to create the missing folds
and to allow the ear to lie closer to the side of the head. Because the
operation is performed from behind the ears, a small scar is left close
to the groove between the ear and the side of the head. The procedure
can be done under local anaesthetic, but in young children general anaesthetic
is usually required. Where the lobe of the ear is especially large, a
small procedure to reduce its size may also be required.
What are the consequences?
A small protective dressing is usually worn after the surgery until
the stitches are removed at between 5-10 days after surgery. Once the
dressing has been discarded, it is wise to wear a protective headband
or bandage when sleeping to avoid the ears being bent forward against
What you should do after the operation?
The hair can be washed after the dressing and the stitches have been
removed. It is important to keep the grooves behind the ears clean.
The operation is most often done during childhood, but it is best to
operate when the patient is five years old or more. Until then the cartilage
is very floppy and does not hold the stitches well. It is recommended
– although parents may feel that their child's ears should be corrected
to avoid teasing and stigmatisation – to wait until the child recognises
the problem and wants the ears corrected. Children are generally more
co-operative and happy with the outcome when they fully understand why
the surgery is taking place. Pinnaplasty is also performed during the
teenage years and in adult life, using either a local or general anaesthetic.
I n children the operation is performed under general anaesthetic,
and this carries with it a very small risk. In a small number of patients
(about 3%) the scars can become thick and red, and may require further
treatment. Infection is not common, but should this occur it would require
treatment with antibiotics and regular dressing changes. Sometimes the
dressing can chafe the ears to produce a break in the skin which can
take a long time to heal. There is a small risk that the repair may
not hold properly, and further adjustment surgery is occasionally required.
The ears are often a little numb after the procedure, and this usually
takes several weeks to settle.