Ear Pinning Surgery (Pinnaplasty, Otoplasty) Cost & Guide

What can ear-pinning surgery achieve?

Pinnaplasty can be performed on both children and adults who have prominent (protruding) ears. The procedure aims to reposition the ears closer to the side of the head, hence reducing the ear prominence and a more aesthetic position.

Prominent or protruding ears can be a great source of self-consciousness for many people. It can affect the way that they choose to wear their hair, their lifestyle choices and even their career choices. This procedure can greatly improve the appearance of the whole face. It can help boost self-esteem, therefore reducing the psychological harm that some people may experience. Medbelle offers the procedures to patients over the age of 18 and, in rare cases, those who are 16 years and over.

How much does ear pinning surgery cost?

Pinnaplasty typically costs between £3,000 and £4,000. There is no fixed price for ear pinning surgery because each procedure is slightly different. During a consultation with a surgeon, a patient has the opportunity to share what they hope to achieve from an ear pinning procedure. The surgeon will use their expertise to make recommendations that they see as important to an individual patient’s situation. These details may incur slightly higher or slightly lower costs; they may include:

• Surgeon experience
• Additional combined procedures
• Surgical techniques
• The time required in surgery for each patient’s case
• The complexity of the individual procedure

Only after the consultation will a final price be offered. Patients can rest easy knowing that there are no additional costs or hidden fees because once that offer is made, it will include:

• Hospital costs
• Surgeon and anaesthetist costs
• Overnight stays (if required)
• Aftercare and follow-up appointments

Why have ear pinning surgery?

The ears are a prominent feature of the face and can have a major effect on its aesthetic. Many people find that they are unhappy with the shape or position of their ears. This can therefore cause them to feel self-conscious about their appearance. The ideal pinnaplasty candidates can therefore include those who have:

• Prominent or protruding ears
• Asymmetrical ears
• Reduced self-esteem due to ear shape or size
• Recurrence from a previous ear pinning

Who is suitable for pinnaplasty?

All ear pinning candidates should be:

• Over the age of six (varies from surgeon to surgeon, Medbelle only offers to those over the age of 18 and in rare cases to those who are 16 years and older.)
• Physically healthy
• Emotionally prepared for surgery
• Unhappy with the aesthetic of their ears
• Non-smokers or have stopped smoking and using all nicotine products for a minimum of 6 weeks before surgery.
• Have no active or ongoing ear infections

Can children have ear pinning surgery?

Prominent ears can be a facial feature that runs in families. Although they do not cause any hearing difficulties, they can be a source of bullying for children. It is, therefore, quite common for children to have ear pinning surgery.

Children that are ideal ear pinning candidates include those who are over the age of six years old. Children younger than six may not be good candidates as their ears have not yet fully matured. Most surgeons also find it important that a child having an ear pinning expresses their unhappiness with their appearance and personally wish to have the position of their ears corrected.

There are no differences in the surgical techniques used for children and adults, although children are more likely to have the procedure done under a general anaesthetic. At present, Medbelle does not offer this procedure to children.

It is important that patients and patients' parents communicate expectations effectively with the surgeon so that they are able to help patients achieve their desired outcomes. Choosing a highly experienced BAAPS/BAPRAS surgeon will mean patients are in the best hands for otoplasty surgery.

How is the ear pinning procedure performed?

An otoplasty typically lasts between one to two hours. It may be done as a day case procedure, or patients may have to stay in the hospital for one night. Before patients go in for pinnaplasty surgery, patients must follow the surgeon’s instructions for eating, drinking, and taking medications the night before surgery.

The Pinnaplasty procedure involves the following steps:

Consent form

On the day of surgery, patients will meet with the surgeon and anaesthetist to sign a consent form for the procedure. Patients may have signed the consent form during the pre-operative appointment a few days or the week before. After signing the form, the surgeon will draw lines around the ears and discuss the exact goals of the procedure.

Anaesthesia

Ear pinning surgery can be performed using general anaesthetic or local anaesthetic with or without IV (intravenous) sedation. The patient and the surgeon will discuss which type of anaesthetic is most suitable prior to pinnaplasty surgery. Children often have the procedure done under a general anaesthetic.

Incisions

The surgeon will make the incision behind the ear. This incision will expose the cartilage so that the surgeon is able to reshape it. Placing the incision in this area means that the scars are generally very well hidden.

Cartilage reshaping

The firm but bendy part of the ear is the cartilage of the ear, and it is this part that the surgeon will reshape and resize during the procedure. Once the surgeon exposes the cartilage beneath the skin, they will reshape and reposition the ears. The technique they choose to use depends on the goals specific to each patient’s ear pinning procedure. After the surgeon reshapes the cartilage, they will secure it into its new position with permanent sutures. These sutures prevent the ears from protruding outwards again.

Closing of incisions

The surgeon will close the incisions using external stitches. They will then wrap a tight bandage around the head. This helps stabilise the ears in their new position. The surgeon will strategically place the incisions behind the natural skin creases or along the hairline so they are visible.

Return to the ward

Patients are then taken back to the ward so that they may recover from the anaesthetic. Once it is safe, patients will be able to return home. Usually, they can go home on the same day of surgery. Although they will be able to see changes instantly after surgery, it can take around six weeks to appreciate the results of pinnaplasty surgery and several months for scars to settle further.

What is ear fold surgery?

Ear fold surgery is a minimally invasive procedure that can correct prominent ears. This procedure involves making a small incision in the ear, then inserting an implant or ‘clip’ to pin back the ears. The implant folds the cartilage back into a less protruding position. Although it is a less invasive treatment than a traditional otoplasty, it may carry a greater risk of re-protrusion.

Although it is a suitable alternative to an otoplasty for both adults and children with prominent ears, it is only suitable for patients with mild prominence and suitable only for select patients. The surgeon will be able to advise you with regard to this.

What is earlobe repair surgery?

Earlobe repair surgery is different from pinnaplasty and is a procedure that repairs stretched or split earlobes. Earlobes can split due to accidental tearing whilst wearing earrings or over-stretching from wearing tunnel earrings. It is a simple procedure that can be done using a local anaesthetic. Patients will be able to see the final results around four to six months postoperatively and can be re-pierced after six months. Many patients are able to have this surgery in combination with ear pinning.

It is important for patients to choose a BAAPS/BAPRAS surgeon to perform any of the above procedures. This will ensure they are in the safest hands during surgery. Even if there is only one ear that is concerning the patient, the surgeon will most likely perform the procedure on both ears so that they are symmetrical.

What to expect during an ear pinning consultation?

The ear pinning consultation will often last between 15 minutes to 1 hour. During this consultation, the surgeon will discuss all aspects of the ear pinning surgery. They will cover past and current medical history, which will include the following:

• Current health status
• Current or pre-existing medical conditions
• Current use of medications, herbal remedies, vitamins, alcohol, tobacco or drugs
• Drug allergies
• Previous surgical history

The surgeon will also discuss various aspects of the procedure. In order to make sure patients are fully informed, they will cover the following topics:

• Reasons for wanting ear pinning surgery
• Expectations of the procedure and desired outcome
• Which surgical approach is the most suitable
• What the ear pinning procedure will involve
• The risks and complications of the procedure

After they cover these topics, the surgeon will then take photos of the ears for the medical record. It is important for patients to be honest and candid with the surgeon about what they would like to achieve from the otoplasty procedure.

Questions to ask during the pinnaplasty consultation:

It may be useful to ask the following questions during the ear pinning consultation:

• Are these expectations realistic?
• Where will the scars be located?
• Request to see before and after photos

The consultation time is the perfect opportunity to ask the surgeon many questions. BAAPS/BAPRAS surgeons want to help patients achieve the best results possible from ear pinning surgery and therefore encourage patients to be as honest as possible.

What are the risks and complications of ear pinning surgery?

All surgeries come with potential risks. It is important to be aware of pinnaplasty risks and complications before having the procedure. These can include the following:

Scarring

Scarring after an ear pinning procedure is unavoidable. This is because the surgeon must make surgical incisions to perform the surgery. The scars, however, tend to be hidden behind the ears. They are strategically placed within the natural skin creases to make them less visible.

The quality of the final scar depends on your skin type. Some patients are more prone to poor-quality scars, such as keloid or hypertrophic scars. Patients are usually already aware of if they are susceptible to developing these types of scars.

Recurrence of prominent ear

In some cases, pinnaplasty may not be successful in pinning the ears back adequately. This may lead to persistent or recurrence of ear prominence. This can, however, be corrected with revision surgery.

Asymmetry

Asymmetry is a normal feature of all human faces. An ear pinning procedure aims to reposition the ears so that they are less prominent and as symmetrical as possible. The healing process, however, may result in slight discrepancies in symmetry.

Stiff ears

When the surgeon adjusts the cartilage in the ear to a different position, the ears can become less flexible and stiff. This is usually due to post-surgical swelling and internal scarring. If the ears do become stiff, this is usually temporary, but it may take several months before they regain their flexibility.

Aesthetic

There is always a risk that patients may be unhappy with the final result of ear pinning surgery. It's therefore advised patients choose their surgeon carefully, making sure they understand the expectations and are highly-experienced members of either BAAPS or BAPRAS.

Altered skin sensation

The surgical incisions that the surgeon makes may damage the nerves in the area that they operate on. This nerve damage can result in numbness or altered sensations (such as pins and needles) developing in or around the ears. In most cases, the numbness will reduce over time, but this can take several months. In some rare cases, the numbness or altered sensation may persist and become permanent.

Bleeding & bruising

Minor bleeding and bruising are common after an ear pinning procedure. In some cases, a blood collection under the skin called a “haematoma” may also form in the skin of the ear. This will often disperse naturally but may sometimes need to be removed with a small needle. It is rare to experience severe bleeding, but if this does occur, it requires a return to theatre.

Suture extrusion

After an ear pinning procedure, the permanent stitches that hold the ear in place may rise to the surface of the skin and irritate the skin in that area. This may lead to the affected part of the ear becoming inflamed. Patients may need to have further surgery to correct this.

Infection

Every surgery carries the risk of infection. These tend to be mild wound infections that can be treated easily with antibiotics. Infections can, however, become more severe if patients do not seek treatment. For this reason, it is important to be aware of the signs of infection. Patients must flag up any of the following symptoms to the surgeon:

• A temperature of 38° C or more
• Foul-smelling pus or discharge from the drains or incision sites
• Redness that is starting to spread away from the incision site
• Increasing pain or discomfort that is not helped by painkillers

Choosing an experienced and highly trained surgeon will minimise the chance of any ear pinning risks and complications occurring.

How to prepare for an ear pinning procedure?

An ear pinning procedure is elective surgery. This means patients will have time to make arrangements to ensure that the recovery goes as smoothly as possible. The following list may help with the ear pinning preparation:

Household chores

As patients will not be able to do any heavy lifting straight after ear pinning surgery, it may be helpful to do food shopping beforehand. It may also be useful to cook some meals and put them in the freezer so that patients do not have to worry about cooking either. It’s good to get chores like cleaning the house, washing, and taking the bins out before going for the otoplasty operation.

Children & pets

Patients will most likely need to arrange for family and friends to help look after young children and pets for the first few days of their recovery.

Contact lenses

As patients will need to wear a headband for five to seven days after surgery, they will be unable to wear glasses. It may therefore be useful to buy prescription contact lenses before having pinnaplasty surgery.

Clothing

As patients will have to wear a headband for the first five to seven days after surgery, patients should try to wear clothes that fasten from the front or back. This will be more comfortable as it prevents pulling clothes over the head and displacing the bandage.

Driving

After the ear pinning procedure, patients will not be able to drive. Patients must therefore arrange for a family member or friend to take them home. In general, patients may not be able to drive for five days to two weeks after surgery. This does, however, depend on the surgeon’s specific instructions.

Diet

To aid recovery after surgery, patients are advised to eat foods that are high in protein and low in salt. Try to have as many fresh fruits and vegetables as possible. Patients should also aim to stay hydrated with caffeine-free drinks and lots of water.

Sleeping

Get plenty of extra pillows for the bed. Sleeping propped up after surgery may be more comfortable. Resting and sleeping on the back in an inclined position may help reduce bruising and swelling after the ear pinning operation.

Surgical advice

It is important to be aware that drinking large amounts of alcohol, having a high BMI, smoking, and using homoeopathic or recreational drugs are all factors that may increase the risk of complications occurring. Smoking, in particular, increases the risk of infections and may delay wound healing. As surgeons always want to reduce this risk as much as possible, they are likely to advise the following:

• Stop smoking and use of all nicotine products for a minimum of six weeks before and after surgery.
• Stop taking all homoeopathic and herbal products at least two weeks before surgery. This includes St John’s Wort, multivitamin preparations and any medications that include: ginger, ginkgo, garlic and cod liver oil.

What to expect after an ear pinning surgery?

After the surgery, the surgeon will give specific instructions for the ear pinning aftercare. Patients will usually be able to return home the same day as the ear pinning but may need to spend a night in the hospital for monitoring.

Swelling & bruising

Patients will likely experience pain, swelling, and bruising around the ears and head after the procedure. This can take one to two weeks to settle, but simple pain relief, such as paracetamol, can be used to ease the pain. Patients should also try to keep their heads elevated, sleep with their heads propped up by pillows, and avoid bending over. These techniques can help reduce post-operative swelling.

Post-operative appointment

The surgeon will schedule a post-operative appointment to attend after the pinnaplasty surgery. This will usually be made within one to two weeks after pinnaplasty. During this appointment, the surgeon or nurse will:

• Examine the surgical area
• Remove any non-dissolvable sutures
• Replace any dressings
• Address any complications
• Discuss the next steps in care.

Another appointment with the surgeon 4-6 weeks post-surgical may be required to assess the result of surgery.

Anaesthetic

If patients were given a general anaesthetic, it may affect memory and concentration after surgery. This will, however, only last one to two days. If patients were given a local anaesthetic, they may feel some altered sensations around the ears, but this will eventually wear off.

Due to the effect of the anaesthetic, it is important for patients to arrange for a responsible adult to stay with them for the first 24 hours after surgery.

Showering & bathing

Patients should be able to shower and bathe from the neck downwards after the pinnaplasty surgery. It is, however, very important to prevent the headband or the ears from getting wet for at least a week. The surgeon will give specific advice regarding showering and bathing.

Compression bandage

After having ear pinning surgery, the ears and the permanent sutures holding them in place will be very sensitive and delicate. Patients will need to wear a tight headband, or compression garment, over the ears and head for around five to seven days. The surgeon may also advise patients to continue wearing the headband whilst sleeping for up to a month after the procedure. This is to help prevent the ears from bending forwards whilst sleeping.

This headband is an important part of the ear pinning aftercare and will help stabilise the position of the ears. It also prevents infection by covering the incision sites. It is very important that patients do not get the headband wet or remove it until the surgeon advises them to do so.

Time off work

The time patients will need to take off work after having pinnaplasty will depend on the type of job they have. If patients have an office job, they should take at least one week off work. If the job involves physical activity or requires the use of headphones (builder, call centre, pilot etc.), they may need to take two weeks or more off work.

Return to sports & exercise

The ears will still remain quite sensitive for a number of weeks after the otoplasty procedure. Therefore, it is essential patients follow the surgeon’s advice on when they can return to sports and exercise. The general guidelines regarding this are as follows:

Recovery Timeline

Week 1

During the first week, avoid all types of exercise and sports. Even minor aerobic sports at this stage may increase swelling.

Week 2 – 3

Two weeks after the ear pinning surgery, patients may resume light cardio activities such as walking on a treadmill. It's advised that patients begin slowly and do not exert themselves.

Week 3 – 4

Three weeks after the surgery, patients can resume more active sports, such as cycling but continue to avoid heavy lifting and strenuous exercises.

Week 4 – 6

After four to six weeks have passed, patients may resume all sports and exercises. Contact sports and activities requiring wearing a helmet should only be resumed after 6 weeks.

Scar care

During the ear pinning procedure, the surgeon will make incisions in the natural skin creases or along the hairline. This allows the scars to be less visible.

To help further reduce the appearance of scars, the surgeon may recommend some of the following techniques:

• Scar massage – gentle massage of the scar area, may aid the healing process. Patients should only do this once their incision has fully healed.
• Silicone sheets, creams or gels – products containing silicone have been proven to help reduce the appearance of scars. It's recommended patients only use these products after the incision fully heals.
• Avoid sun exposure – It's advised to avoid sunbathing or using sunbeds. If, however, patients do expose the scar to the sun, be sure to use high-factor sun cream. This protects the healing skin and avoids darkening the scar.

Results

Although patients will be able to see a difference in the ears immediately after the ear pinning surgery, it can take around three to six months to see the full cosmetic results. It is, therefore, important to be patient. Following the surgeon’s advice on ear pinning aftercare will help yield the best possible results.

The final results should be life-long. There may, however, be some changes to the ear shape that are naturally seen with ageing. If any complications that alter the shape of the ear occur, such as re-protrusion, the surgeon can correct this with further surgery.

A cosmetic ear pinning procedure is not normally available on the NHS. It may, however, be carried out if there is evidence of significant psychological distress.

Most surgeons are happy to see you for an ear pinning consultation without a referral from your GP. They may, however, need to contact your GP for details of your medical history.

In rare cases, some medical conditions may need a sign off from your doctor prior to having the surgery, but your Patient Care Adviser will let you know if this applies to you.

There is no difference between the Otoplasty and Pinnaplasty procedures. They are two different names that describe the same surgery, and are both also known as “ear pinning”.

As you will have to wear a headband after the ear pinning procedure, you cannot wear glasses at the same time. You will need to wear the headband day and night for 5 to 7 days and for up to 6 weeks after surgery whilst you are sleeping. You should therefore wait until you no longer need to wear your headband to resume wearing your glasses again. This is so that you do not alter the newly set position and shape of your ears. This will usually be 3 weeks after surgery but can take longer. You should therefore consider buying prescription contact lenses for this time period.

It is extremely unlikely that an ear pinning procedure will affect your hearing. The ear is made up of 3 parts: the outer ear (the pinna), the middle ear and the inner ear. All 3 parts contribute to hearing, but it is mainly the middle and inner ear that affect it.

The pinna is the only part that your surgeon will operate on during your ear pinning. The role of the pinna is simply to carry the sound waves into the middle and inner ear to allow you to hear. It is, therefore, highly unlikely that surgery to this area will affect your hearing. Choosing a highly experienced BAAPS/BAPRAS surgeon will greatly reduce the risk of potential complications.

Smoking, taking recreational drugs and consuming large amounts of alcohol are all factors that increase the risk of complications occurring during and after surgery. We therefore strongly recommend that you stop smoking and using any nicotine products for at least 6 weeks before and after your operation.

All of the information found on our website is sourced from highly reputable experts, and government-approved authorities and is widely used by healthcare professionals.

• https://www.nhs.uk/conditions/cosmetic-procedures/ear-correction-surgery/ NHS
• https://baaps.org.uk/patients/procedures/14/setting_back_prominent_ears British Association Of Aesthetic Plastic Surgeons
• https://www.bapras.org.uk/public/patient-information/surgery-guides/ear-surgery British Association of Plastic, Reconstructive and Aesthetic Surgeons

Our content is written by our Medical Quality Managers and Patient Care Advisers, all of who have medical backgrounds and training. Prior to publishing, all the information is reviewed by a surgeon specialised in the relevant field.