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Article by Scott Kasden

Photography by Scott Kasden

Otoplasty (“Ear Pinning”)

What Will It Do For Me?

This procedure will not only move the ears closer to the head, or “pin” the ears. It also shapes the ears, and where indicated, can also be used to reduce the actual size of the ear. Otoplasty will eliminate merciless teasing that occurs on the school grounds and allow the patient to wear hair up or down, long or short, without feeling- self conscious. The operation restores harmony to the face by moving attention away from the prominent ears, and in so doing, enhances the natural attractiveness of the face.

Additional Procedures: Procedures commonly performed at the time of otoplasty lip augmentation, chin implant, and Coblation TM, to name a few.

Who are the best candidates?

The best candidates are healthy individuals who do not smoke. Age is not as important as overall health, however, this procedure is best done when the patient is around seven or eight years old (when ear development is nearly complete, and the school yard teasing and torment has not psychologically damaged the child). The ideal candidate has prominent ears that affect the overall appearance and self-esteem of the patient., A caring and supportive family is crucial..

Associated Risks

Risks associated with this procedure are few and uncommon. The complications include wound healing problems, and occasional decrease/loss of sensation in the operated site. There are muscles behind the ear which must be altered during the procedure, so people who can vigorously move the ears prior to surgery, will not be able to do so afterward.. Most of these complications are minor and temporary.

Preparation for surgery

After you are evaluated in the office, you may be required to avoid certain medications for about two weeks prior to surgery. It is important to let Dr. Kasden know all the medications you are taking including over the counter medications and herbal medications/supplements. If you smoke, quit at least two months before surgery.

Where will it be performed?

The procedure is usually performed in the office under local anesthesia with mild oral sedation, however, it may also be performed in hospital or surgery center, under general anesthesia on an outpatient basis.

Surgical Process:

After you are under anesthesia, an incision is made in the between the back of the ear and the skull. Excess skin is removed and the ear cartilage is shaped, trimmed, and in some cases reduced as needed. After the shaping is completed, sutures are placed in the cartilage skeleton of the ear to maintain shape, and the wound is meticulously closed to hide the scar in the crease behind the ear.

How Will I feel Afterward?

This procedure is uncomfortable, not really painful. Appropriate medications will be given to help with the discomfort. Most people feel groggy for a while after the surgery, but after a day or so, report feeling great.

Back to Normal?

You can expect to have pain/discomfort for about a week or so, which will still be touchy for many weeks, especially if it is accidentally bumped. There is significant swelling of the ears which is mostly resolved after about a week. You will need to wear a headband for 3 weeks after surgery to protect the delicate work, and after that you may resume most activities. Contact sports are prohibited for about 2 months.

Results to Expect

You should expect that the ear will have an aesthetic size & shape, and will no longer be prominent. The natural attractiveness of your face will be greatly enhanced because the ear has been returned to a more harmonious relationship with your face, and in fact now “frames” your face. As a result, the eye is naturally drawn to your face and not your ears.


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Frontal view (pre-op, left) showing prominent ears resulting from lack of folding of the ear cartilage with overdevelopment of the “concha” cartilage that pushes the ear away from the skull.

Also not that the ears are asymmetrical, with the left ear more prominent and slightly shorter (vertically).

Post-op front view showing improved ear position and symmetry. Nothing reasonable could be done to improve the shorter vertical dimension of the left ear, but this asymmetry is barely noticeable.

Notice that with the ears closer to the head, the eyes tend to focus more on the face, which is more attractive with the ears in a better aesthetic position.

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Quarter view (pre-op, left) demonstrates suboptimal folding of the (anti helical) helix with deep, hypertrophied concha cartilage. Post-op, the ear foldings are improved after surgery which not only brings the ear back, closer to the head, it improves the overall shape.

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Side View (Pre-op, left) Shows that the lack folding also causes some “cupping” of the upper portion of the ear. Post-op, the helix (outer folded portion of the ear) no longer folds over (cups) the ear. The shape is also improved, and looks natural, un-operated.

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Posterior view (pre-op, left) shows the new position and shape of the ears post-op ( right). There are not tell tail signs of surgery, even with a short haircut! Enter text.