Otoplasty, commonly called ear pinning surgery, is a procedure that corrects ears that stick out too far from the head. It is one of the most common cosmetic surgeries performed on children and adults in Canada. This guide explains what otoplasty involves, who it helps, what risks to expect, and how to prepare for the procedure.
What Are Prominent Ears?
Prominent ears — sometimes called “stick-out ears” — sit farther from the head than usual. This happens because of a difference in the ear’s cartilage structure, not because of anything a parent did during pregnancy. The condition is congenital, meaning a person is born with it. However, it is not directly inherited, so it can appear randomly in a family.
Prominent ears affect men and women equally. Worldwide, about 5% of people have this condition. The ears may appear slightly larger than average and tend to protrude noticeably from the side of the head. For many people, this causes self-consciousness, particularly in children who may face teasing at school.
What Is Otoplasty?
Otoplasty is a surgical procedure that changes the shape, position, or size of the outer ear. Surgeons use it most often to move prominent ears closer to the head. It can also correct other structural differences that a person finds bothersome. According to the Mayo Clinic’s overview of otoplasty, the procedure focuses entirely on the outer ear — the visible part you can see and touch.
It is important to understand what otoplasty does not do. It cannot correct problems inside the ear canal or fix the eardrum. As a result, it will not change your hearing in any way — even if something unexpected happens during surgery. This is purely a cosmetic procedure for the outer ear.
Does Otoplasty Work on Both Ears?
Surgeons typically perform otoplasty on both ears at the same time. This helps achieve a balanced, symmetrical appearance. However, if only one ear is affected, surgery may be done on just that side. Your surgeon will assess your ears carefully before making this decision.
Can You Have a Second Otoplasty?
Yes. If you have already had otoplasty and are not happy with the result, a second procedure is possible. Surgeons generally wait for full healing before performing a revision. The waiting period gives tissues time to settle and gives the surgeon a clearer picture of what needs to be corrected.
Who Is a Good Candidate for Otoplasty?
Otoplasty is most often recommended for children between the ages of 5 and 7. By age 5, the ear cartilage is fully developed and stable enough for surgery. After age 7, the ear reaches its mature shape, which can make the procedure slightly more complex. For children born with prominent ears, this age window tends to give the best results.
Adults are also good candidates for otoplasty. For example, if an injury changes the structure of your ear at any age, surgery can help restore a natural appearance. Adults who have always disliked their ear shape can also choose to have the procedure at any point in life. There is no upper age limit, provided you are in good overall health.
A plastic surgeon will use specific measurements to confirm whether you are a candidate. These include the distance between the ear and the mastoid bone (the bony area behind the ear) — typically at least 2 centimetres — and the angle between the ear and the side of the head, usually at least 30 degrees. These measurements help determine whether surgery is truly recommended for your situation.
Risks and Complications of Otoplasty
Like any surgery, otoplasty carries some risks. Most complications are uncommon, but it is important to understand them before you decide to proceed. Healthline’s guide to otoplasty risks and recovery offers a thorough breakdown of what patients can expect.
Common Risks Include
Unexpected bleeding: Significant bleeding during or after surgery is possible but rare.
Local infection: The surgical site can become infected, requiring treatment with antibiotics.
Reactions to anaesthetic: Some people experience adverse reactions to local or general anaesthesia.
Scarring: All surgery leaves scars. However, skilled surgeons place incisions behind the ear so scars are hidden and not easily visible.
Keloid scars: People prone to raised, thickened scars (called keloids) may develop them at the incision site.
Asymmetry: During healing, one ear may retract slightly differently than the other, creating a small imbalance in appearance.
Temporary numbness: The skin around the ear may feel numb or less sensitive after surgery. This is usually temporary and resolves on its own.
Allergic reactions: Some patients react to materials used during surgery, such as sutures or antiseptic solutions.
Over-correction: In some cases, the ears are brought in too close to the head, creating an unnatural look that may require revision surgery.
Furthermore, your surgeon will review all of these risks with you before the procedure. Make sure you ask questions and feel confident in your understanding before giving consent.
How to Prepare for Otoplasty
Preparation begins with a thorough consultation with a plastic surgeon. During this first appointment, your surgeon will review your medical history, examine your ears, and discuss your goals for the surgery.
Your First Consultation
Be ready to share your full health history. Your surgeon will ask about past ear infections, hearing problems, previous ear surgeries, and any known allergies. This information helps the team plan the safest approach for you or your child.
Your surgeon will also examine the size, shape, position, and symmetry of your ears. In many cases, photographs are taken and kept in your file. These “before” photos are compared with “after” photos to track results. You will also discuss your expectations honestly — what you hope the surgery will achieve and what is realistically possible.
Medications and Supplements
Your surgeon will advise you to stop taking certain medications before surgery. Anti-inflammatory drugs like aspirin can increase bleeding risk. Natural health supplements — including fish oil, vitamin E, and herbal products — can also thin the blood. Therefore, always tell your surgeon about every medication and supplement you take, including over-the-counter products.
Smoking
Smoking reduces blood flow to the skin and slows healing significantly. If you smoke, your surgeon will ask you to stop for at least a few days before and after surgery. Ideally, quitting entirely gives your body the best chance to recover well. Health Canada’s smoking cessation resources can help if you are ready to quit.
On the Day of Surgery
Otoplasty is performed in a hospital or surgical centre. Some patients receive local anaesthesia with sedation — meaning only the ear area is frozen and the patient remains awake. Others require general anaesthesia, where the patient is fully asleep. Your surgeon and anaesthesiologist will decide together which option is best for you.
Make sure you arrange for someone to drive you home after the procedure. You should also have someone stay with you on the first night following surgery. This is standard practice for any outpatient procedure done under sedation or general anaesthesia.
When to See a Doctor
If you or your child has prominent ears and you are considering otoplasty, the first step is to speak with your family doctor. They can provide a referral to a plastic surgeon through your provincial health plan. In some cases, if you do not have a regular family doctor, a walk-in clinic physician can also start the referral process.
You should seek prompt medical attention after surgery if you notice signs of infection — such as increasing redness, warmth, swelling, or discharge — or if you experience severe or worsening pain. Unexpected bleeding or high fever after any surgical procedure always warrants immediate care.
Always speak with a qualified medical professional before making any decisions about cosmetic surgery. This article is for informational purposes only and is not a substitute for personalised medical advice from your doctor.
Frequently Asked Questions About Otoplasty
Is otoplasty covered by provincial health insurance in Canada?
In most provinces, otoplasty is considered a cosmetic procedure and is not covered by provincial health plans when done for appearance reasons alone. However, if the surgery is deemed medically necessary — for example, to correct a significant structural abnormality — some coverage may apply. Check with your provincial health authority and speak with your family doctor to understand your options.
What is the best age for a child to have otoplasty?
Most surgeons recommend otoplasty between the ages of 5 and 7 for children born with prominent ears. By age 5, the ear cartilage is developed enough to hold its corrected shape. Acting before age 7 tends to produce the most natural-looking results, as the ear is still maturing during this window.
How long does recovery from otoplasty take?
Most patients recover from otoplasty within one to two weeks, though full healing of the deeper tissues can take several months. You will likely wear a bandage or headband around your ears for the first week or two to protect the area and maintain the new position. Your surgeon will give you specific recovery instructions tailored to your situation.
Will otoplasty leave visible scars?
Otoplasty does leave scars, but surgeons are careful to place incisions in the natural crease behind the ear, making them very difficult to see. For most patients, the scars fade significantly over time and are hidden by the ear itself. People prone to keloid scarring should discuss this risk with their surgeon before proceeding.
Does otoplasty affect hearing?
No — otoplasty does not affect hearing in any way. The procedure only addresses the outer ear (the visible part), and it does not involve the ear canal, eardrum, or any internal hearing structures. Even in the unlikely event of a surgical complication, your hearing will not be changed by this procedure.
Can adults get otoplasty, or is it only for children?
Adults can absolutely have otoplasty at any age, provided they are in good general health. Many adults choose the procedure if they were not treated as children, or if an injury later changed the shape of their ears. There is no upper age limit for otoplasty, and results in adults are generally very positive.
Key Takeaways
Otoplasty is a safe, well-established surgery to correct prominent ears that stick out from the head.
The condition affects about 5% of people worldwide and is not directly inherited.
The ideal age for children is between 5 and 7, but adults can have the procedure at any age.
Otoplasty only affects the outer ear — it does not change hearing in any way.
Risks include infection, asymmetry, scarring, and temporary numbness, but serious complications are uncommon.
Preparation involves stopping certain medications, quitting smoking, and arranging post-operative support at home.
Start the process by speaking with your family doctor or visiting a walk-in clinic to get a referral to a plastic surgeon.
Always consult a qualified medical professional before making any decision about surgery.
