HMT Sancta Maria Hospital, Swansea

Setting Back Prominent Ears

(also referred to as Pinnaplasty)

A number of people are unhappy with the shape of their ears. They may consider them to be too prominent and/or large. The shape of the ears often runs in families and may be inherited. In very prominent ears, there may be a lack of a normal fold. One ear is sometimes more prominent than the other. Prominent ears can sometimes lead to teasing and a subsequent lack of confidence. The school years can be a particularly difficult time.

Treatment

If the ears are noticeably prominent during the first few weeks after birth, this can be corrected by the application of small splints. The ear cartilage is much softer and pliable in a newborn baby, allowing correction of the prominence after a few weeks of splinting. The cartilage becomes progressively stiffer and, by the age of 6 months, reshaping through splinting is no longer possible. Surgery to correct prominent ears is often carried out during childhood. It is recommended that the child is at least five years old. Before this age, the child’s cartilage may be too floppy to hold the stitches properly.

The surgical procedure to correct prominent ears is known as pinnaplasty. The shape of the cartilage is adjusted by making an incision behind the ear and scoring or suturing the cartilage. This creates the missing fold and allows the ear to lie closer to the side of the head. This leaves a small scar close to the groove behind the ear.  Surgery can be carried out either under local or general anaesthetic. 

In young children, a general anaesthetic is usually advised. If the ear lobes are very large, this can be adjusted by means of an additional small incision to reduce the size. 

Limitations

A small minority of patients may require a further minor adjustment to achieve a satisfactory shape to their ears. However, the majority of patients are very pleased with their result. Pinnaplasty has a high satisfaction rate

Post Surgical Care

Dressings, padding and a protective bandage will be usually be worn for 10-14 days or until your first follow up appointment. The ears will be sore and tender initially, requiring analgesia such as paracetamol and/or codeine. Aspirin should be avoided in the first week following surgery to minimise the risk of bleeding. If you have had a general anaesthetic, expect to stay one night in hospital.

What to expect following surgery

Any non absorbable sutures will be removed at your first follow up appointment, along with any padding. It is recommended that you continue to wear a bandage or protective headband at night for about six weeks, to avoid the ears being bent forward and disturbing the healing incisions. Following your first follow up appointment you will be able to wash your hair. It is important to keep the skin behind the grooves clean.

You may notice numbness or tingling in your ears after surgery. This can take a few weeks to settle. There may also be some breakdown of the skin due to pressure from the dressing and bandaging. This can take a long time to heal.

It is best to avoid sports, especially contact sports for approximately six weeks.

The scar can be a little red and lumpy in some patients. The surgeon may advise gentle massaging with an ointment to reduce this.

Risks

All surgery carries an element of risk. This includes pain, bleeding and infection. These risks are not common in patients who have Pinnaplasty. An infection would require treatment with antibiotics and extra dressing changes. Bleeding risks can be minimised by avoiding aspirin and other anti-inflammatory drugs.

There is a small risk that the initial surgery may not hold properly, leading to the need for another procedure.

Following the surgeon’s instructions will help to minimise any risks. All patients are given a discharge sheet before leaving hospital to remind them of any instructions along with details of their first follow up appointment.

The information contained in this website is not exhaustive. A full consultation with a suitably qualified plastic surgeon will enable you to have your individual requirements and risk factors assessed and to ensure that this type of surgery is suitable for you.

Sources/Further Information:

· British Association of Aesthetic Plastic Surgeons (BAAPS)

· British Association of Plastic Reconstructive & Aesthetic Surgeons (BAPRAS)

· Department of Health  Cosmetic Surgery: Information for Patients (August 2006)