The aim of pinback otoplasty surgery is to reshape the cartilage and pull the ear closer to the head. The cartilage can be reshaped in two ways, with stitches and by weakening or cutting the cartilage. It has been shown that when the cartilage is weakened on one side it will curl away from that side.
Both these methods are used to reshape the antihelix and reposition the concha. Sometimes both methods are used at the same time. If the concha is very large a small part may also be removed. Other parts of the ear may be reduced in size by removing part of the cartilage although some surgeons prefer to do this as a separate operation.
The cartilage is reached by making an incision in the skin behind the ear. The incision is closed with stitches that may need to be removed. Sometimes the earlobe will also be repositioned closer to the ear and made smaller. The surgery may be performed under a local anesthetic in adults, but in children, and some adults, a general anesthetic is preferred.
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It is important to remember that no surgeon can give a guarantee about the final outcome, including appearance, shape, size and so on. You should have a realistic attitude about the outcome, and remember that all surgery has good and bad aspects. That there is no such thing as ‘perfect surgery’.
The satisfaction rate for cosmetic surgery is around 90% and although a satisfactory outcome is anticipated this means that 10% of people do not achieve the result that either the patient or the surgeon would like.
If things do not go well you may need revision or secondary surgery. Although many surgeons do not charge for this, there is often a charge for anesthesia and operating room costs.
After surgery the skin is allowed to redrape over the new shape and held in position with dressings which mold the ear.