What is it and how is it done?
Otoplasty, widely known as ear pinning or prominent ear correction, aims to bring ears that stand out too far from the head into a more natural position. Prominent ears are usually present from birth and generally have two causes: the fold in the upper part of the ear (the antihelix) has not developed fully, and the bowl around the ear canal (the concha) is deep or large. Sometimes an earlobe that points forwards adds to the picture. A difference between the two ears is common and is taken into account in the surgical plan.
Ear pinning can be done from the age of 5–6, when the ear has largely reached its adult size. Many families choose the period before the child starts school; the child's own wishes and ability to follow the headband rules are also part of the decision. There is no upper age limit for adults. In children the operation is usually performed under general anaesthesia; in adults and in teenagers who can cooperate, it is usually done under local anaesthesia, with sedation if needed.
The incision is made behind the ear, in the natural crease where the ear joins the head. The antihelical fold is recreated with permanent stitches, and a deep concha is set back with stitches or reduced; if the cartilage is stiff and thick, its front surface is thinned or scored to help shape it. Which techniques are combined depends on the structure of the ear and the stiffness of the cartilage. Prof. Dr. İlker Yazıcı has published a peer-reviewed article in this field ("Posterior auricular muscle flap as an adjunct to otoplasty", Aesthetic Plastic Surgery, 2009) and a book chapter describing the same technique (2013); in this technique a small muscle behind the ear is used as a flap to support the otoplasty.
After surgery, a soft dressing protects the ears for a few days. An elastic headband is then worn to stop the ears folding forwards during sleep; it is usually worn day and night for the first 1–2 weeks and then only at night for a few more weeks. The exact period is decided at the check-up.
Ear reconstruction, for example after loss of the ear through injury, burns or tumour surgery, or for a small or underdeveloped ear present from birth (microtia), is a separate area of reconstructive surgery that requires different techniques. At the consultation in Nişantaşı, Prof. Dr. İlker Yazıcı assesses the structure of the ears and the difference between the two sides, and explains the anaesthetic and surgical options suitable for you or your child.
What are the aims?
- To set the ears closer to the head at a natural angle.
- To make the fold in the upper part of the ear (the antihelix) more defined.
- To set back or reduce a deep or large concha.
- To reduce the difference between the two ears.
- To achieve a natural shape that does not look operated on, with the rim of the ear still visible from the front.
Who is it suitable for?
- Children from about 5–6 years of age, when the ear has largely finished growing.
- Teenagers and adults who are bothered by prominent ears; there is no upper age limit for adults.
- People with an underdeveloped ear fold, a deep concha or an earlobe that points forwards.
- People with a noticeable difference between their two ears.
- Children and adults who want the operation themselves and can follow the headband and aftercare rules.
- People whose general health allows anaesthesia.
When is it postponed or not recommended?
- Children under 5 whose ears are still developing; ear moulding in newborns is assessed separately.
- Children who do not want the operation or will not be able to follow the headband rules; in this case surgery may be postponed.
- People with an active infection in or around the ear, a skin problem such as eczema, or a middle ear infection; surgery is postponed until it has been treated.
- People who have previously developed keloids (excessive, raised scars); the risk is assessed separately at the examination.
- People with an uncontrolled bleeding disorder or another health problem that rules out anaesthesia.
Alternatives
- Ear moulding in newborns
- A special moulding device started in the first weeks after birth, while the cartilage is still very soft, can correct the shape without surgery in some babies; it becomes less effective as the baby grows.
- Earlobe correction only
- If the problem lies only in an earlobe that points forwards or is large, a smaller procedure under local anaesthesia may be enough.
- No surgery
- Prominent ears do not cause any health problem; if a child or adult is not bothered by their ears, not having surgery is an equally valid choice.
The process step by step
- 1
First contact
You can send photos of the ears from the front, back and side (for children, together with their age and general health) and a short description of your concerns by WhatsApp or e-mail, or call the practice. This information gives you a general idea of the options and helps plan the examination; the medical assessment and the decision take place at the examination in Nişantaşı.
- 2
Consultation
At the practice in Nişantaşı, Prof. Dr. İlker Yazıcı assesses the ear fold, the depth of the concha, the stiffness of the cartilage and the difference between the two ears, and asks whether the child wants the operation. You receive a written plan and cost information.
- 3
Preparation
The necessary blood tests and an anaesthetic assessment are carried out; fasting before surgery, current medication and the rules for postponing surgery in case of a feverish illness are explained.
- 4
Surgery
The operation is performed in an accredited partner hospital, under general anaesthesia in children and usually under local anaesthesia in adults, and generally takes 1–2 hours; most patients go home the same day.
- 5
Dressing and check-ups
The first dressing is removed at a check-up a few days later and replaced with an elastic headband; if dissolvable stitches were not used, the stitches are removed on day 7–10.
- 6
Long-term follow-up
Check-ups usually take place at 1 and 3 months; the scar behind the ear and the position of the ears are assessed for the last time within a year.
Recovery timeline
Days 1–3
A soft dressing covers the ears; throbbing and tenderness are controlled with painkillers. Pain in one ear that increases suddenly and does not respond to medication can be a sign of a blood collection; in that case, call the clinic straight away.
Days 3–7
The dressing is removed at a check-up; the ears may look swollen and slightly purple. The elastic headband is worn day and night. Most children return to school by the end of this period.
Week 2
The stitches are removed or begin to dissolve, and swelling reduces noticeably. The headband can be taken off during the day but is still worn at night.
Weeks 3–6
The headband is worn only at night. Avoid contact sports with a risk of a knock to the ear, and swimming, until your surgeon gives approval.
Month 3
Swelling has largely settled; tenderness and sensitivity to cold in the ears decrease.
Months 6–12
The scar behind the ear becomes thinner and paler; the final position of the ears is assessed during this period.
Risks and possible complications
Every surgical procedure carries risks. Your personal risk is assessed in detail at the consultation.
- Collection of blood (haematoma): rare but needs prompt treatment; pain and swelling that increase suddenly in one ear are the most important sign.
- Infection and inflammation of the cartilage lining (perichondritis): shows as redness, increasing pain and fever; early treatment is important.
- Partial return of the prominence: can happen when stitches loosen over time, especially with stiff cartilage; a minor revision operation is sometimes needed.
- A remaining difference between the two ears, or an ear that looks pinned too flat against the head.
- A stitch that can be felt under the skin, works its way out or causes a small inflammatory lump around it (granuloma).
- A thick scar or keloid behind the ear; the risk is higher in people who are prone to them.
- Temporary numbness, tenderness and sensitivity to cold in the ear.
- A sharp edge or irregularity on the surface of the cartilage.
- Risks related to anaesthesia; for children, a separate anaesthetic assessment is carried out.
What determines the cost?
The cost of ear pinning varies from person to person, so it would not be accurate to quote a single figure before an examination. The main factors are whether one or both ears are operated on, whether additional corrections such as earlobe surgery are needed, the type of anaesthesia (general or local), the length of the operation and hospital costs.
After the examination with Prof. Dr. İlker Yazıcı, you receive a written, itemised quote for the planned procedures that states what is included. Ear reconstruction after an injury or for a shape abnormality present from birth is planned and costed separately.
If you are coming to Istanbul
The practice is authorised by the Turkish Ministry of Health for international health tourism (certificate no. ST-2365); help with accommodation near the clinic and airport transfer can be arranged through authorised partners. Patients and families travelling from abroad or from another city for ear pinning should plan to stay in Istanbul for about 3–5 days after surgery, until the first dressing check; depending on the type of stitches used, this may extend to 7–10 days. Back home, you stay in touch with the practice by sending photos and messages; if something needs to be examined, a check-up in Istanbul or a visit to a local doctor is arranged. Return visits to the practice are usually advised at 1 and 3 months.
Frequently asked questions
At what age can ear pinning be done?
Ear pinning can be done from the age of 5–6, when the ear has largely reached its adult size. Many families plan it for the period before the child starts school, but the child's own wishes and ability to follow the headband rules also matter. The same operation is done in teenagers and adults, with no upper age limit. For prominent ears noticed in a newborn, ear moulding in the first weeks of life may be an option.
Is otoplasty painful, and will my child be put to sleep?
You feel no pain during otoplasty. Children usually have a general anaesthetic; adults and teenagers who can cooperate usually have a local anaesthetic, with sedation if needed. In the first days after surgery there is throbbing and tenderness, which is usually controlled with simple painkillers. If pain in one ear increases suddenly and does not respond to medication, call the clinic straight away.
What should I know about medication and smoking before ear pinning?
Before ear pinning, every medicine being taken should be mentioned at the consultation. Blood thinners such as aspirin and some herbal supplements can increase the risk of bleeding; which ones to stop, and when, is decided together with your doctor. For adults, not smoking for a few weeks before and after surgery supports wound healing. If a child has a feverish illness, a cough or an ear infection, surgery is usually postponed until they have recovered.
Does ear pinning leave a scar?
In ear pinning the incision is made behind the ear, in the natural crease where the ear joins the head, so the scar is usually not visible from the front and becomes thinner and paler over time. As with any operation, a permanent scar forms; in some people, especially those who are prone to it, the scar can thicken or a keloid can develop. If you have had a scar problem like this before, mention it at the examination.
How long is the headband worn after ear pinning?
After ear pinning, the soft dressing that protects the ears usually stays on for a few days and is removed at the first check-up. An elastic headband is then used: it is usually worn day and night for the first 1–2 weeks, then only at night for about 4–6 weeks. The aim is to stop the ears folding forwards during sleep and to protect the stitches. The exact period is decided at the check-up, according to how the ears are healing.
When can my child go back to school, or I go back to work, after ear pinning?
After ear pinning, most children return to school within about a week, and adults return to desk work within 5–7 days. During this period the headband covers most of the ears. Ball games, contact sports and activities with a risk of a knock to the ear usually wait 4–6 weeks; when swimming can be resumed is decided at the check-up, depending on how the wounds are healing.
Can ears stick out again after otoplasty?
The shape achieved with otoplasty lasts for many years in most people. However, because cartilage is elastic, the ears can spring back slightly in the first months, especially when the cartilage is stiff, which is why following the headband rules matters. If the ears move back noticeably, a minor revision operation may be needed. The final position of the ears usually settles within 3–6 months.
What does the cost of ear pinning depend on?
The cost of ear pinning depends on whether one or both ears are operated on, whether additional corrections such as earlobe surgery are needed, the type of anaesthesia (general or local), the length of the operation and hospital costs. For this reason it would not be accurate to quote a single figure without an examination. After the examination with Prof. Dr. İlker Yazıcı, you receive a written, itemised quote based on the planned procedures.
Can ear surgery be combined with another operation?
In adults, ear surgery can be planned in the same session as another facial operation such as rhinoplasty; in that case general anaesthesia is usually preferred and the recovery periods are considered together. Small corrections, such as reducing a large earlobe or repairing a torn one, can also be added to ear pinning. Which procedures can be combined is decided at the examination, taking into account the total operating time and general health.
We are travelling to Istanbul for ear pinning. How many days should we stay?
Patients and families travelling to Istanbul for ear pinning are usually advised to plan a stay of 3–5 days after surgery, until the first dressing check has been done. Depending on the type of stitches used, this may extend to 7–10 days. Return visits to the practice are usually requested at 1 and 3 months, and in between you can stay in touch by sending photos and messages.
Last updated: · Responsible for content: Prof. Dr. İlker Yazıcı · info@ilkeryazici.com