How much does war pinning cost? Can I finance? What are the chances that my ears will return
to the current look?
As you can tell, my ears stick out quite a bit, my whole life I've been bullied and have
taken extreme measures to "hide" them like tie a shoelace around my ears for a couple
years to the point it left a dent on the top of my head, to gorilla taping them back and
in the process of taking the tape off, ripping some hair out of my head. I refuse to show
my ears and I am 23 years old, I just want to be able to go swimming, or tie my hair
up on a hot day. I'll never feel confident without surgery.
Thank you for your question!
You’ve submitted a question where you described how distressed you are about having prominent
ears and you submitted some photos in an interesting way where I can see part of the ears and different
angles and get some kind of a sense of what your concern is and you want to know about
ear pinning surgery.
So what I’ll do for you is first educate you a little bit about what happens commonly
for people with prominent ears and what are the steps we go through in a cosmetic surgery
practice like mine. I’m a board certified cosmetic surgeon and I’ve been practicing
in Manhattan and Long Island for over 20 years and ear surgery of different types do come
to our practice. When it comes to prominent ears, we have to do a proper analysis to give
a sense of what is recommended and then we’ll discuss the options that we offer.
So when we look at an ear, we are looking at a few key elements when someone’s main
concern is about the ears being prominent. There are 3 parts to this area: one is called
the under development or lack of development of the antihelical fold. The other is called
conchal hypertrophy or prominent concha and the third is a protuberant or a more outwardly
pointed earlobe. So in general, when people complain about ears, we have to anatomically
identify or 1, 2 or all 3 of these elements are part of the situation.
Now the surgery for prominent ears is referred to as otoplasty. Otoplasty, “oto” meaning
ear, “plasty” meaning to change from the Greek word “plasty” or change “plasticus”.
So when making a decision, it’s generally desirable to try to do the procedure in way
that is predictable, that is consistent and likely to succeed. In my practice, what I
generally do, for a typical situation where all 3 elements are part of the whole complex,
in other words, lack of development of the antihelical fold, a promienent concha or the
central part and the protuberant earlobe, we’ll do something called a surgical otoplasty.
Now that this involves is doing procedures that are from behind the ear, inside the crease
of the ear. All the work is basically done from there. And what we are trying to do from
behind the ear is recreate the fold. If there is too much of this conchal bulge, we resect
part of that and bring the conchal bulge against the mastoid or the mastoid fascia and the
prominent ear lobe is also brought in and that more kind of the design of the incision.
Now this is somewhat in contrast to other procedures which you may have heard of like
a set-back or pulling of the ear, the important thing is identifying the anatomic issues.
Every surgeon who does this has their preferred technique and in adults, we have the luxury
of doing this with a little bit of cooperation because in this type of procedure, we routinely
do, I should also mention, under local anesthesia with LITE™ IV sedation. So one of the many
challenges is that first, we have to create aesthetically a nice-looking ear and then
we want to have the ear symmetric with the other side. So we want elements of the ear
to look good.
Now one of the things to also understand about this surgery is that when a person heals,
there may be some asymmetry. And sometimes you have to go back and do enhancements. Now
in our practice, we explain to the patients that if they need enhancements, whether a
stitch breaks or something happens where an earlobe is still a little bit prominent, we
can always enhance those areas. But for most people who are older than teenagers, this
is the way we do this surgery.
I think it’s important that you now meet qualified experienced cosmetic surgeons because
even though you are submitting a good set of photos, you’re not going to get a true
sense of what is needed unless someone does a proper physical examination. Once that physical
examination is done, you understand the risks and benefits of doing this surgery and of
course, learn about where the surgery is done.
My personal bias is because we office-based surgical facilities that are certified by
the Joint Commission, I always feel for a comfort, it’s much nicer for a patient to
have it done in an office setting versus a hospital or even a surgery center because
of how much attention one gets in a private office setting. In our situation, we try to
consistently provide that. And I also prefer local anesthesia with LITE™ sedation because
this is the type of surgery where you really don’t need general anesthesia for. Now that’s
my opinion. Now of course there’s an exception when it comes to the operating of this procedure
on children. Of course, children cannot cooperate therefore a general anesthesia is appropriate.
So again, I would recommend meeting with qualified experienced cosmetic surgeons. This information
should help guide you as you do your research in understanding where your ear fits in this
scheme. When I look at your photos, it looks like your antihelical folds look pretty good
and it was a little bit difficult to tell whether the ears were prominent from the center
part of the ear. But again, physical examination, there are certain standards and then what
I do is I try to look at how the ears look relative to the patient’ face and how much
they desire in terms of going in. a lot of times, people who have prominent ears want
them really flat like they’re almost stuck to their heads and that never looks right.
There’s a certain measurement, by a centimeter where the ear is away from the bone that it
looks very good. But again, we customize the procedure for every patient.
So I hope that was helpful, I wish you the best of luck and thank you for your question!