Otoplasty, also known as pinnaplasty or ear pinning, is an operation to reshape and set back prominent ears so that they sit closer to the head and in better proportion with the face. At her Harley Street practice in London, Ms Anna De Leo performs otoplasty for both adults and children, with scars concealed in the crease behind the ear and an emphasis on soft, natural contours rather than ears that look pinned flat.
Prominent ears are common and entirely harmless, but they can have a real effect on confidence. Children may be teased at school, and many adults have spent years styling their hair to hide their ears. Otoplasty is one of the most satisfying procedures in plastic surgery because a relatively short operation can bring a lasting change in how people feel about themselves. As a female plastic surgeon with a strong reconstructive background, Ms De Leo takes particular time to put both parents and patients at ease.
01What Is Otoplasty?
The outer ear is shaped by a framework of flexible cartilage covered by thin skin. Ears usually look prominent for one or both of two reasons: the natural fold of cartilage near the rim, called the antihelical fold, is underdeveloped or absent, or the deep bowl of the ear, the concha, is unusually large and pushes the whole ear outwards. Less commonly, the earlobe itself is prominent.
Otoplasty corrects these features by reshaping the cartilage. Through an incision placed behind the ear, a small ellipse of skin is removed and the cartilage is remodelled and repositioned, either with permanent internal stitches that recreate the missing fold, by gently scoring or thinning the cartilage, or by setting back the concha. Often a combination of techniques is used. Because the incision faces the side of the head, the scar is concealed in the natural groove behind the ear.
Otoplasty can be performed on one ear or both. Importantly, it changes only the shape and position of the outer ear and does not affect hearing.
02Otoplasty for Adults and Children: Who Is It For?
Children
The ear reaches most of its adult size by around five or six years of age, which is why, in line with UK guidance, otoplasty is not usually performed before the age of five. Many families choose to consider it around the time a child starts or settles into primary school. What matters most is that the child is aware of their ears, wishes for a change themselves and can cooperate with dressings and aftercare. Ms De Leo will always listen to the child as well as the parents, and surgery will only be recommended when it is genuinely in the child's interest.
For newborns, prominent ears can sometimes be corrected without surgery using ear moulding splints, which work best when started within the first few weeks of life while the cartilage is still very soft.
Teenagers and adults
There is no upper age limit for otoplasty. Adult cartilage is firmer, so techniques may be adapted, but results are typically excellent. You may be a good candidate if you are in good health, bothered by the prominence or shape of your ears, and have realistic expectations about a natural, balanced result.
03Your Otoplasty Consultation on Harley Street
Your consultation takes place at 64 Harley Street, in the heart of Marylebone, London. Ms Anna De Leo will take a medical history, examine the shape, size and position of each ear and the strength of the cartilage, and identify which part of the ear is responsible for the prominence. She will discuss what you, or your child, would like to change, and show how a natural result is defined: ears that sit comfortably, with the rim still visible from the front.
Pre-operative checks are tailored to your health and, where needed, may include blood tests. For children, Ms De Leo explains the plan in a calm, age-appropriate way and discusses the choice of anaesthetic with parents.
The factors that influence the cost of otoplasty include whether one or both ears are treated, the technique, the anaesthetic (local or general) and your aftercare. These are set out in a clear written plan. For cosmetic surgery, GMC guidance recommends a cooling-off period of at least two weeks between consultation and surgery, giving you and your family time to reflect and ask questions.
04Otoplasty Techniques Tailored to Your Ears
Adults usually have otoplasty under local anaesthetic, sometimes with light sedation, while children generally have a general anaesthetic for their comfort and safety. The operation is performed as a day case in an accredited London hospital and typically takes around one to two hours, depending on whether one or both ears are treated.
- Cartilage-sparing (suture) techniques: permanent fine stitches are placed in the cartilage to fold it and create a natural antihelical fold, or to set back the concha towards the head.
- Cartilage-modifying techniques: where cartilage is stiff, it can be gently scored or thinned so that it folds more easily, then secured.
- Conchal reduction: a small crescent of cartilage may be removed when the bowl of the ear is particularly deep.
- Earlobe correction: a prominent lobe is repositioned with a small skin adjustment.
The skin is closed with fine sutures and a padded head bandage is applied to protect the shape while early healing takes place. Ms De Leo pays close attention to symmetry and to the smooth curve of the rim, so that the ears look natural from every angle.
The best ear correction is one people never notice: the ears simply sit naturally, so attention returns to the person, not their ears.
ADLSynergy · Harley Street
05Otoplasty Recovery Time
Recovery from ear pinning is generally straightforward, and most people are surprised by how quickly they feel themselves again. A typical course is:
- First 48 hours: a compressive head bandage protects the ears. Discomfort is usually mild to moderate and controlled with oral pain relief for around three days.
- Up to day 7: a lighter dressing or headband is worn. Hair washing is avoided for around ten days to reduce the risk of infection.
- Days 7–10: any non-dissolving sutures are removed. Adults return to desk work and children to school after one to two weeks.
- Around one month: a soft elastic headband is worn at night to protect the ears while you sleep. Swelling and sensitivity gradually settle.
- 6 weeks: contact sports and swimming can usually resume, on advice.
Our Harley Street team in London supports you throughout, with practical advice on dressings, scar care and comfortable sleep. Ms De Leo remains on hand for reassurance at every stage.
06Otoplasty Risks and Results
Otoplasty is a well-established procedure, but every operation carries some risk, which will be explained before you decide:
- Bleeding or a haematoma under the skin, which may need to be drained
- Infection, usually treated effectively with antibiotics
- Thickened, raised or keloid scars behind the ear, which may need steroid injections
- Temporary numbness or tenderness of the ear
- Stitches that become visible or irritated through the skin and need removing
- Asymmetry between the ears or an over-corrected, ‘pinned-back’ look
- Partial return of prominence over time, occasionally requiring revision
Otoplasty does not affect hearing. When viewing otoplasty before and after photographs, remember that every ear is different and results vary; small differences between the two sides are normal, just as they are in unoperated ears. For the great majority of patients, the change is permanent.
07Why Choose Ms Anna De Leo for Otoplasty on Harley Street
Ms Anna De Leo is a GMC-registered Plastic, Reconstructive and Aesthetic Surgery Consultant and Fellow of the European Board of Plastic, Reconstructive and Aesthetic Surgery. Her reconstructive training, including a European Master's degree in reconstructive microsurgery and experience correcting congenital malformations, brings a deep understanding of cartilage and the three-dimensional structure of the ear.
Families often tell us they value a calm, unhurried surgeon who explains everything clearly to children and adults alike. As a female surgeon, Ms De Leo combines precision with warmth and patience, which matters greatly when the patient is young or anxious.
Whether you are an adult who has always wanted to change your ears or a parent seeking advice for your child, you are welcome to book a consultation at our Harley Street practice in London.
