How close can prominent ear correction bring the ears? How ear-pinning works and relapse tendency

Prominent ear correction is a surgical procedure that creates an ear fold by suturing or incising the ear cartilage, bringing ears that appear to project away from the head closer to the side of the head[1][2]. A report summarizing 18 studies showed the distance between the head and ear edge decreased from an average of 27.1 mm to 15.4 mm[3]. However, prominent ears tend to have a higher relapse rate compared to treatment of other ear shape deformities[1].

What is done in prominent ear correction?

Most commonly, the back of the ear is incised to expose the cartilage, and sutures are used to create a fold that brings the ear closer to the side of the head[2]. The incision is hidden behind the ear and is difficult to see from the front[2].

Methods include suturing the cartilage, incising the cartilage, and clips placed without cutting, all of which have received certain clinical validation[1]. Methods that can be performed under local anesthesia have also been reported[2].

What is the difference between cartilage-cutting and non-cutting methods?

The method of creating shape with sutures without cutting cartilage is reported to cause less tissue damage and results in a more natural-appearing fold[4]. The cartilage-cutting method has stronger shape-changing power but has reports of blood accumulation, uneven surface, and higher relapse rates[4].

Reports summarizing research also showed good results with non-cartilage-cutting methods[3]. However, the same method does not work for all ears, and the combination is chosen based on the individual ear shape[5].

How does surgery change concerns?

Prominent ear is the most common congenital ear shape and does not affect hearing function[5]. The reason for considering surgery is usually cosmetic concerns, such as being teased at school[5].

Japanese guidelines summarize that after surgery, mood improves and improvements are observed in social relationships, concentration, and initiative[1].

Can the ears return to their original position?

Yes, relapse can occur. Analysis of summarized research showed a relapse rate of 2.8% and revision surgery rate of 2.1%[3].

Sutures loosen somewhat over 3 to 4 months, so some reports recommend positioning the ears slightly more tightly during surgery[5]. Adults with stiff cartilage or ears taller than 5 cm are reported to have higher relapse rates[6].

What complications should we watch for?

The most common is sutures used to secure the cartilage protruding through the skin, seen in 5.4%[3]. When all complications are combined, a rate of 14.4% has been reported[3].

Immediately after surgery, hematoma (blood accumulation) and infection can occur, and keloid (raised scar tissue) can develop over time[7]. Issues such as pus accumulation around the sutures have been reported to be managed appropriately in most cases[2].

Is there a non-surgical method if done during childhood?

If performed shortly after birth, there is a method of using a mold to shape the ear without surgery (ear molding)[7][8]. One study found that wearing the mold starting around 6 days after birth for approximately one month achieved good results in 92.6%[8].

Mold correction is considered more effective when started earlier, but certain results have been reported even in children past the optimal timing[7]. When cartilage becomes too stiff for the mold to reshape, surgery becomes the primary approach[5].

What does the doctor examine during consultation to determine which method suits your ears?

Prominent ear correction is a surgical procedure that creates and repositions an ear fold, and relapse and suture complications occur at certain rates. Which method is suitable is determined by the physician during consultation by examining the degree of ear projection, cartilage firmness, and asymmetry between ears[6].

Communicate how close you want your ears brought, and discuss management if relapse occurs or sutures protrude during your consultation.