Otoplasty (Ear Pinning) in Thessaloniki and Athens, Greece

Otoplasty is the surgical correction of prominent ears. Through an incision behind the ear, I reshape the cartilage so that the concha (the deep bowl of the ear) is reduced and the antihelix fold is formed. The ear moves closer to the head and keeps its natural folds.

Ears stick out for different reasons. Either the concha is too deeply curved, or the antihelix, the fold in the middle of the ear, has not formed fully. Often both play a part, and not always to the same degree in the two ears.

At the examination I identify which of the two causes is present in each ear, because they are corrected differently. During the operation I check both ears together. The aim is not an ear “pinned flat” against the head, but a natural outline and the same appearance from the front.

Otoplasty does not affect hearing: the operation involves only the skin and cartilage of the outer ear, while the inner ear lies much deeper.

Otoplasty suits children from the age of 4 and adults with prominent or asymmetric ears. In children I prefer the age of 4 to 6, before they start school. In adults it is done under local anaesthesia (anesthesia), with no hospital stay, and there is no upper age limit.

At the consultation I examine each ear separately and we decide together what needs correcting and whether one or both ears are treated. We discuss the type of anaesthesia, which depends mainly on age. You leave with a written plan and a quote. Before surgery, blood tests are done where needed and fasting instructions are given.

What we cover at the consultation

I examine each ear separately: the concha, the antihelix, the earlobe, the distance of the ear from the head and the symmetry between the two ears. We decide together whether only the concha, only the antihelix or both need correcting, and whether one or both ears will be operated on. We discuss the type of anaesthesia, which depends mainly on age. With children, a parent is present and we talk about how to prepare the child. You receive a written plan and a quote.

A note for parents. If your child covers their ears or grows their hair long to hide them, it is enough to tell them that this can be corrected. Do not push them into the operation. The decision works best when the child wants it too, because then they also cooperate during recovery, for example by wearing the headband.

Tests and instructions before surgery

Blood tests are done where needed, depending on age and the type of anaesthesia; when a child is operated on under general anaesthesia, the anaesthetist also carries out a pre-operative assessment. Fasting instructions are given before the operation; for children, food stops 6 hours and clear fluids 1 hour beforehand. Adults who smoke should ideally stop at least 4 weeks before and 4 weeks after surgery. If you take anticoagulants or antiplatelet medicines, tell me; they are only stopped in agreement with the doctor who prescribes them. The date is set once the tests are complete; for children, a school holiday is often convenient so that they do not miss school.

Otoplasty takes about 1 hour. From the age of 10 it is done under local anaesthesia as a day case; younger children usually have a general anaesthetic. The incision is behind the ear, and depending on the problem I reduce the concha, shape the antihelix with special stitches or weaken the cartilage.

Even under local anaesthesia the operation is painless, because the area is completely numbed. In children under 10 I usually use general anaesthesia, which lasts about 1.5 hours in total, and the child goes home the same day. The technique is adapted to each ear. In every operation I check both ears side by side throughout, to achieve the greatest possible symmetry.

Correcting the concha

When the ear sticks out because the concha is deep, I remove the excess cartilage. The curvature is reduced and the ear moves closer to the head without its outline changing. An alternative is to fix the concha to the bone behind the ear (the mastoid) with stitches (Furnas technique) [3].

Shaping the antihelix

When the antihelix fold is missing or incomplete, I create it with permanent stitches on the back surface of the cartilage (Mustardé technique [1]). The resulting fold is smooth.

Weakening the cartilage

When the protrusion is marked or the cartilage is stiff, I weaken the front surface of the cartilage so that it bends in the right direction and the risk of the ear coming back out is reduced (Stenström principle [2]). This matters more in adults, whose cartilage is less elastic.

A technique tailored to each ear

I adapt the technique to specific problems: asymmetry between the two ears, a prominent upper part of the ear or a protruding earlobe. When only one ear sticks out, both are usually operated on for symmetry.

Incisions and stitches

The incision is behind the ear, in the crease where it meets the head, and the scar cannot be seen from the front. Sometimes a small incision is also needed on the front surface, hidden in the folds. The skin stitches are removed on day 5; the internal stitches in the cartilage are permanent.

Combining otoplasty with other procedures

In older patients, I usually correct large or protruding earlobes during a facelift. We discuss other combinations at the consultation.

Hospital stay

The operation is done without an overnight stay: you go home the same day with a bandage around your ears. You must not drive after a general anaesthetic, and children always leave with a parent.

The ears stay bandaged for one week and the skin stitches come out on day 5. You return to school or work after 1 week and to your normal activities after 2 to 3 weeks. Once the bandage is off, you wear a headband for 3 weeks. Pain is mild to moderate and settles with ordinary painkillers.

In children the pain lasts 1 to 2 days, in adults 4 to 5 days, because adult cartilage is less elastic.

Otoplasty needs no overnight stay in hospital: you go home the same day. The skin stitches are removed on day 5 and the bandage at the end of the first week, so plan to stay in Greece for 5 to 10 days before flying home.

On the day of surgery you go back to your hotel or accommodation with a bandage around your ears. You must not drive after a general anaesthetic, and children always leave with a parent. The bandage stays on for the first week, and the skin stitches come out on day 5. I recommend you wait until at least day 5, after the stitches are out, before flying.

Once home, you wear a headband for 3 weeks after the bandage comes off. After you return home, follow-up is by video call at 10 days, 1 month, 6 months and 1 year. Before you travel, arrange the following at home:

• ordinary painkillers for the first days;
• a headband to wear for 3 weeks once the bandage is off;
• your flight for day 5 or later, since the stitches are removed at the practice on day 5;
• time off school or work for about 1 week, and no swimming or sport for 1 month.

If anything worries you once home, such as pain or redness, you should be examined promptly, and you can contact me directly: message the practice on WhatsApp and you receive a reply the same day.

The results of otoplasty are permanent. The ears reach almost their final shape within a few months, and the scar behind the ear becomes barely visible by month 6. Recurrence is rare; I can show you the exact rate in my own patients at the consultation.

In children, correction before school can limit teasing. In adults it allows a free choice of hairstyle. The ear reaches almost its full size at around age 6.

Serious complications are rare, and hearing is not affected because the inner ear lies much deeper. The most common risk is the ear coming back out (recurrence), usually because a stitch gives way. The table below sets out each risk in detail; I explain the risks for your own case at the consultation.

Smoking. In adults I recommend stopping at least 4 weeks before and 4 weeks after the operation; smoking increases healing complications.

Anticoagulants. If you take anticoagulants or antiplatelet medicines, tell me at the consultation. The decision to stop them is always made by the doctor who prescribes them.

I do not publish prices. The cost depends on the anaesthesia (local or general), on whether this is a first or a secondary operation, and on any combination with another procedure. You receive a quote after the consultation and examination, together with your written plan for one or both ears.

• Anaesthesia: general in children under 10, local from age 10.
• First or secondary otoplasty.
• Whether one or both ears are operated on.
• Combination with another procedure, e.g. earlobe correction with a facelift.