Pinnaplasty

Prominent ear correction

Prominent ear correction is one of the most gratifying procedures for both patient and surgeon. The results are fairly instant and the effect on a persons confidence can be quite dramatic.

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There are several features of the ear that give the shape, and the absence or over-expression of one or more of these features can lead to prominence of one or both ears.

The aim of surgery is to correct these features to give the appearance of a normal ear. At the end of the procedure, I hope patients will have ears that look natural and do not look ‘pinned back’.

Your pinnaplasty journey

Consultation

During the consultation, I will explore the reasons for you requesting a pinnaplasty. We will discuss what you expect from the surgery and the ideal shape you are hoping to get. I will examine you and take some measurements that will guide me in giving the correct advice.

The Procedure

Anaesthetic

The procedure usually takes about 90 minutes and requires a general anaesthetic. In a few cases, if requested specifically, the procedure can be performed under a local anaesthetic but this will be uncomfortable for a few minutes while the local anaesthetic is being injected.

Size

Shape

Incision

Sutures

Dressings

Post-surgery

Post-surgery

I will see you immediately after surgery to discuss how things went and to check that all is well. I will make sure you are comfortable before you go home. Patients are able to go home the same day. You will be given adequate pain relief. Please avoid taking any aspirin or blood thinning medication such as nurofen (ibuprofen) or voltarol (diclofenac).

Recovery

For the first 48 hours following surgery, please minimise the activities you are undertaking. Sleep with 3-4 pillows to keep your head elevated. This will help the bruising and swelling to come down quicker. Any activity that increases your blood pressure may trigger bleeding. You may return to work after a week when the bandage comes off; you will be able to shower and wash your hair then.

Eat well and stay well hydrated by drinking lots of fluids. Abstain from alcohol for at least a week as this can cause dehydration. Smoking or use of any nicotine replacement product is to be avoided for at least 6 weeks before surgery and after surgery to allow the body to heal as quickly as possible.

You may return to driving after 48 hours if you feel comfortable and able to maintain full control of the vehicle. You may fly ideally after 4 weeks, but make sure you drink plenty of fluids (not alcohol) and wear flight stockings on your calves.

Avoid any trauma such as contact sports for 12 weeks

Scar management

After 3 weeks, wounds have generally healed. You are advised to gently massage the scars as tolerated as this helps to soften, flatten and desensitise them. You may use any lotion of your choosing, such as E45 or bio-oil. 5 minutes morning and evening for about a year. Make this part of your ‘routine’. Secondly, scars tan faster than normal skin. Therefore avoid exposing the scars to the sun, but if you have to, then apply factor 50 sun block daily, for a year. It takes about a year for a scar to fully mature and caring for your scars in this manner will ensure optimal healing. In some cases, I may advise using silicone gel (such as Kelocote), to be smeared onto the scar daily for a year.

Potential Complications

General anaesthesia

Pinnaplasty, whilst safe, can result in complications and it is important you are fully aware of them. This is why there is a 2-week ‘cooling-off’ period to allow you to make a considered decision about proceeding with surgery.

Any operation involving a general anaesthetic carries a risk of developing blood clots in the calves (deep vein thrombosis – DVT), which could break off and move to the lungs causing a pulmonary embolism (PE). Early mobilisation and keeping hydrated will reduce this risk, as will avoiding smoking before and after surgery for at least 6 weeks. There is a risk of allergy to the drugs for anaesthetic and antibiotics/pain relief, and a very small but theoretical risk of major life-threatening complication/death related to the anaesthetic (1 in 100,000 risks).

Bleeding and haematoma

Infection

Scar

How it heals depends on your body’s ability to heal scars. The scars will be red for a few weeks before becoming pale over the course of the first year. In a small number of patients, the scar may become thick and lumpy (hypertrophic or keloid scar) and this is a result of your body’s healing process. For reasons not completely understood, the ears are a particular site for keloid scarring; however the risk is less than 2%. If keloid scars do develop, they are very difficult to treat, and may require long term treatment with compression garments, steroid injections and in extreme cases, surgery to debulk it.

Asymmetry

Skin sensation

Swelling

Recurrence

Over time, there is a possibility that the ears will try and return to their pre-surgery position. In this instance, they may need correcting again.

The outcome of all cosmetic surgery is highly subjective. Whilst your surgeon will try to give you a realistic expectation, the satisfaction which you feel about your result depends on many things.

Most people are delighted with their outcome. If there are elements of your surgery which fall short of what you had hoped for, you MUST feel free to discuss them with me, as the majority of issues are easily resolved.