Ear Pinning Surgery (Otoplasty): What to Expect
Ear pinning surgery, or otoplasty, brings ears that stick out closer to the head by reshaping the cartilage behind them. The incisions are usually on the back of the ear, so scars are typically well hidden. Most people spend about a week recovering at home, and healing is largely complete about three weeks after surgery at Center for Plastic Surgery. Children can be evaluated any time after age three, and adults can have it too.
Whether you are a parent watching your child become self-conscious about their ears, or an adult who has quietly disliked them for years, the questions tend to be the same: is it the right age, what actually happens, and how long until life is back to normal. This guide answers them, drawing on our otoplasty page at Center for Plastic Surgery and published patient guidance.
What Ear Pinning Surgery Changes
Otoplasty changes the shape of the ear cartilage so the ear sits closer to the head. It does this by removing portions of the cartilage, or by forming the natural folds of the ear where they are missing.
The American Society of Plastic Surgeons (ASPS) lists what ear surgery can treat:
Protruding ears: on one or both sides, in varying degrees.
Overly large ears: a condition called macrotia.
An earlier ear surgery you are unhappy with: adults can have a previous result revisited.
Cleveland Clinic groups otoplasty into a few types, and ear pinning is the one for ears that stick out more than you want them to. Ear reduction and ear augmentation for small or underdeveloped ears are separate procedures. The goal of ear pinning is balance and proportion with the rest of your face, not an ear flattened against the head. ASPS notes that techniques are individualized to avoid an unnatural "pinned back" look.
Children, Teens and Adults: Who It Suits
Otoplasty suits both children and adults. As some children grow, their ears protrude noticeably further than those of their peers. About ninety percent of ear growth is complete by age three, so a child can be assessed any time after that point. At our practice, corrective surgery is most commonly performed at age five or six, but it can be performed well into adulthood.
What makes someone a good candidate differs a little by age. This summary comes from the ASPS candidate guidance:
| Children | Teens and adults | |
|---|---|---|
| Typical timing | Generally around age 5, once the ear cartilage is stable enough | Can be performed well into adulthood |
| Health | Healthy, with no untreated chronic ear infections | Healthy, with no condition that would slow healing |
| Smoking | — | Nonsmokers |
| Readiness | Cooperative, follows instructions, and does not object when surgery is discussed | A positive outlook and specific goals of their own |
For a child, how they feel matters as much as the timing. ASPS looks for children who can say how they feel about their ears and who do not object when surgery is discussed. For adults, ASPS puts it plainly: ear surgery is something to do for yourself, not to meet someone else's wishes. Our post on questions to ask yourself before choosing plastic surgery is a good place to start that reflection. Men considering the procedure can also read our page on otoplasty for men.
What Happens During the Procedure
Ear pinning is an outpatient procedure, so most patients go home the same day. Depending on the patient's age and how much correction is needed, it is performed under general anesthesia or local anesthesia with sedation, given by one of our board-certified anesthesiologists.
The steps, as ASPS describes them:
Incision: usually on the back of the ear. If an incision is needed on the front, it is placed within the ear's natural folds.
Reshaping: the surgeon creates or deepens the fold just inside the rim of the ear and reduces enlarged cartilage in the bowl of the ear.
Securing the shape: internal, nonremovable sutures hold the newly shaped cartilage in place.
Closing: external stitches close the incision and a dressing supports the new shape.
Cleveland Clinic notes that otoplasty generally takes one to three hours, depending on your situation. In cases of protruding ears, ASPS describes the change as visible almost immediately once the supporting dressings come off.
What Recovery Looks Like
Most of the healing happens in the first three weeks. Here is how recovery typically unfolds at Center for Plastic Surgery:
Days 1–5: a turban-type head dressing stays in place for three to five days. ASPS warns that removing it early may mean losing some of the correction, so it stays on even if it itches.
After the dressing comes off: a light dressing goes over the ears. Many children wear a ski-type headband during this phase.
Days 10–14: most bruising and swelling has resolved.
Week 2: normal exercise can usually resume.
Week 3: ears are wrapped at night until this point, and healing is largely complete.
Week 6: contact athletics can usually resume.
Cleveland Clinic notes that most people recover at home for about a week, and that children returning to school still need to hold back on recess, sports and gym class for a while. It also suggests sleeping on your back, avoiding touching your ears, and choosing button-up shirts so nothing pulls over your head. Cleveland Clinic advises avoiding sun exposure and wearing earrings or glasses until your surgeon says it is fine. Swelling can make the ears look larger for a short time. Everyone heals differently, so stick with your surgeon's timeline.
Risks and Limits to Know About
Ear pinning is generally considered safe, but like any surgery it carries risks. The ASPS risk list for ear surgery includes:
Anesthesia risks
Bleeding, including a collection of blood under the skin (hematoma)
Infection and poor wound healing
Asymmetry between the two ears
Changes in skin sensation, such as numbness
Unfavorable scarring
Discomfort that persists
The possibility of revision surgery
There are honest limits, too. Otoplasty changes how the ear looks, not how it works, and ASPS notes that good results are expected, but complete satisfaction cannot be promised, and a second procedure is sometimes needed. Call your surgeon if you notice fever, swelling or redness that is getting worse, fluid from the incision, or discomfort that your medication does not ease. These are among the warning signs Cleveland Clinic lists.
To see how other patients' ears looked before and after, browse our otoplasty photo gallery. For questions about fees, see our pricing and cost information page. Our financing page explains payment options, including CareCredit®.
Interested in Otoplasty in Washington, D.C.?
Center for Plastic Surgery has been helping patients with ear pinning since 1986. Our board-certified plastic surgeons, including Dr. Samir S. Rao, care for children and adults from Washington, DC, Chevy Chase, Bethesda, Arlington, Fairfax, and surrounding areas, and operate in a private, AAAASF-certified ambulatory surgery center. Call our Chevy Chase office at (301) 652-7700 or our Tysons Corner office at (703) 560-2850, or request a complimentary consultation to talk through whether otoplasty is right for you or your child.
Frequently Asked Questions
Does ear pinning surgery affect hearing?
No. Otoplasty reshapes the outer ear, which is the part you can see. Cleveland Clinic notes that it does not change or improve your hearing, and the American Society of Plastic Surgeons describes the protruding ears it treats as not associated with hearing loss. If you or your child has a hearing concern, that is a separate conversation with your doctor.
If only one ear sticks out, do both ears need surgery?
Not always, but often. Cleveland Clinic explains that even when only one ear protrudes, the procedure usually involves both ears so they end up symmetrical. Your surgeon will look at both ears together and explain the recommendation at your consultation.
Why is a headband worn after the dressing comes off?
It helps hold the ears in their new position while the cartilage settles. At Center for Plastic Surgery, a light dressing replaces the head dressing after three to five days, many children wear a ski-type headband during this phase, and ears are wrapped at night for three weeks. Cleveland Clinic describes a supportive, flexible headband worn for a few weeks, especially while sleeping.
Can ears move back out after otoplasty?
It is uncommon. Our otoplasty page notes rare instances of a mild recurrence of the protruding ear, which can be corrected under local anesthesia. The American Society of Plastic Surgeons stresses keeping bandages in place, because removing them early may mean losing some of the correction and needing a second surgery. Following your aftercare instructions is the best protection.
About the Author
October 28, 2026