Ear Pinning: Everything You Need to Know

by Dr. Jason Martin 

April 21, 2020

he best option for prominent ears: Ear Pinning (aka Otoplasty)

The way our ear develops before birth is fairly miraculous.  Small little outcroppings called hillocks coalesce together during development and make what we know after birth as our ear.  And make no mistake, our ear is very complex.  It has three main regions that include external, middle and inner portions.  What we can see with our naked eye is the external portion.  The external portion has many different components that form its overall shape.  Unfortunately, the anatomical names of these structures aren’t that easy to remember, so to help you understand, here are the non medical descriptions:

Helix          The rounded external edge of the top of your ear

Anti helix.  Area underneath your helix that normally has a forked ridge of cartilage

Tragus.      Elevated cartilage in front of your ear that you press to decrease sound

Lobule        Ear lobe and the area you pierce for ear rings 

Concha      The cartilage bowl that encircles you ear canal

(Insert anatomical diagram of the external ear)

The interesting part of how your ear looks is that all the structures listed above can have an effect on how your ears appear.  For example:

1. The helix can be less rounded and more pointy.  Also, it can flop out from your head which makes it more visible.

2. The anti helix, a common culprit in prominent ears, makes the top half of your ear appear more prominent when the cartilage in this area is less developed (no forked ridges).

3. The tragus can be oddly shaped and more visible in some people.

4. With age, our earlobes can hang and appear larger.

5. An over developed concha can make your whole ear stick out further from your head (rotate forward) 

As you can see from above, the way your ear developed before you were born is why you have prominent ears.  As plastic surgeons, our job is to figure out which part of your ear is the problem and then fix it permanently with surgery.  This is why your first office visit is so important.  From your exam, we will be able to tell you confidently why your ear is prominent and what exactly needs to be addressed with the procedure.  Below is a quick run down of all the possible steps of an ear pinning procedure.    We mix an match these steps as per your problem areas on exam:

1. Reshape a helix that is pointy and add structural support if it tends to flop out

2. Restore a normal contour to the anti helix and re build the forked ridges (crus) by shaping the cartilage with sutures (Mustarde technique) or with an abrasion technique.

3. Reduce the prominence of the tragus and remove any accessory cartilage 

4. Earlobe reduction (crescent versus wedge technique)

5. Make the concha less prominent by removing cartilage and using sutures (Furnas Technique)

Deciding which one of these steps is best for you comes from experience.  But if you engage an office like ours that specializes in this procedure, these steps are very routine.  Our results are definitive and consistent but the best part is that you will love the change: natural yet less prominent appearing ears.

Here are a few things you need to know about an ear pinning procedure in our office.

1. For adults, a majority of these procedures can be completed in the office under local anesthesia. 

2. Ear pinning procedures are commonly combined with other procedures, especially nose jobs, facelifts, necklifts and Facetite procedures. 

3. In most cases, only a short incision in the crease behind your ear is needed, thus the scars from this procedure are rarely visible.

4. Recovery is a breeze and pain is minimal. As you will need to wear a compression band over your ears for 1-2 weeks after surgery, there will be some social downtime.

5. The results are long lasting if you follow the post operative instructions

Check out our Beauty and the Surgeon Podcast for more information on an ear pinning procedure.

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