Pinnaplasty

Surgery is carried out through an incision hidden in the fold on the back of the ear. After gently lifting the skin off, the cartilage at the front of ear is gently scored with a blade to allow the ear to curve towards the head and create the fold which is missing in a prominent ear.

Once the operation is completed, the skin is re-draped, and the incision is closed with dissolvable sutures, which do not need to be removed. A crepe bandage is put around your head to protect your ears as they are healing and to prevent any bleeding.

The procedure takes approximately one hour to perform.

The procedure can be carried out either under local (when you are awake, but the area is numb) or general anaesthetic (you will be fully unconscious). This is normally carried out as a day case, so you do not need to stay overnight in the hospital.

Ear surgery is not particularly painful. However, for the first few hours, your ears may throb and ache and/or you may feel sick. Any discomfort is usually quick to resolve and only requires simple analgesia for pain relief.

Providing all is well, you can expect to go home the same day as your operation.

Having cosmetic surgery should be a very positive experience. Complications are infrequent and usually minor. However, all surgery has risk, and it is important that you are aware of possible complications. All the risks will be discussed in detail at your consultation. However, if you have further questions or concerns, please do not hesitate to discuss them with me. Decisions about cosmetic surgery should never be rushed.

These risks can be divided into those specific to the surgery and those that relate to the anaesthesia.

General Anaesthetic risks: An anaesthetic is very safe, however, should a complication arise, the relevant medical expertise is immediately available to deal with this.

The risks increase if you have certain medical problems, which will be discussed at length during the consultation. The risks include:

• Unintended intraoperative awareness, which is very rare.
• Dizziness and nausea.
• Sore throat.
• Damage to teeth or mouth.
• Nerve injury due to body positioning.
• Allergic reaction or anaphylaxis.
• Malignant hyperthermia, which is a rare life-threatening condition.

The anaesthetist will go through these risks in more detail prior to your surgery.

Scars: These are hidden behind the ear and tend to settle remarkably well and are barely perceptible. However, some patients heal with noticeable thickened, thin or stretched scars.

Bruising and swelling: This is very common and may take a couple of weeks to settle.

Haematoma: This can happen if a bleed occurs under the skin, allowing a large blood clot to form. However, if a haematoma does develop it tends to occur within 4 to 6 hours post-surgery.

Any increase in pain in the ears should be reported immediately so that treatment can be given. Sometimes patients need to have this blood washed out with another short operation. As long as a haematoma is treated in good time then it should not affect the result of surgery.

An untreated haematoma can lead to deformity of the ear cartilage similar to ‘cauliflower ears’’ caused by contact sports and often seen in rugby players or fighters.

Infection: This is rare but may require a course of antibiotics to prevent problems with the shape of the cartilage.

Wound healing problems: These are very rare but more likely to occur if there is an untreated haematoma or infection. This can cause pressure on the skin and cartilage, possibly resulting in a deformity in the cartilage or loss of the skin. Further surgery may be required if this occurs.

Asymmetry: Ears are never identical as our faces are asymmetrical. Whilst I will always endeavour to improve symmetry, it may not be possible to completely correct, due to the confines of your anatomy.

Unpredictable results: As cartilage is living tissue and its shape can occasionally alter over time, results can be unpredictable. Rarely, a second operation may be required to refine your results.

Deep Vein Thrombosis/Pulmonary Embolism (DVT/PE): Following any surgical procedure it is possible to develop a blood clot in your legs, which could potentially break off and travel to your lungs. If the blood clot is large enough, it could prove fatal.

The overall risk for cosmetic surgery is less than 1%, but to reduce any risks of a DVT/PE, you will be provided with special stockings to wear in bed together with a blood thinning injection, if you are not mobile or have previously had a DVT or PE.

All of the risks outlined above will be discussed in detail at your consultation with me. However, if you have further questions or concerns, please do not hesitate to ask.

You will have a dressing and bandage around your head, which will need to stay in place for approximately one week.

The bandage is there to help the ears maintain their new shape, whilst healing takes place.

You will be given an appointment to see the nurse a week after your surgery to remove the dressing. At this stage you should not require any further dressings.

I would recommend that you purchase a soft tennis headband to wear in bed at night or during contact sports for the next 4 weeks. This ensures that the ear is maintained in a comfortable position, whilst still healing.

I will see you in clinic at about 2 weeks or sooner should you have any problems.

If you have any worsening pain or bleeding, please contact us for further advice.

Scar Advice
Once the dressings are removed, I recommend that you massage the incisions, using small circular motions at least twice a day for 5 minutes. You can use any moisturising cream of your choice and apply firm pressure until it blanches.

The scars will also benefit from silicone scar gel (ScarAway® or Kelo-Cote®) twice a day, which will soften and fade them, as well as applying sunblock for 12 months to provide sun protection.

The ScarAway® can be purchased from Healthcare Pharmacy at Governors Square in Grand Cayman.

You should take things easy for the first week and most patients return to work by 1 week. With the head dressing remaining in place, you can return to normal activities. I would recommend that you avoid contact sport for 4 weeks following surgery.

For self-funding patients, surgical fees are a combination of the hospital costs, the surgeon, anaesthetic fees and any consumables. I do not charge additional fees for post-op appointments. The fees are based on the surgical time taken to perform the surgery, rather than procedure itself. This means that the costs are calculated fairly.

You will be given a quotation for surgery approximately 48 hours following your consultation.

Pinnaplasty - Nicotine and Surgery

Pinnaplasty - Local Anaesthetic Pre-Op Instructions

Pinnaplasty - General Anaesthetic Pre-Op Instructions

Pinnaplasty - Post-Op Instructions