Kids at school, on the playground, and even on the Internet can be cruel. Kids with conspicuous body blemishes are often the target of verbal assaults and psychological bullying. Large protruding ears have long been the bane of children throughout history as they have been teased with names like "dumbo". Fortunately, today there is a cosmetic surgery that can possibly eliminate these jokes. It is called Otoplasty or ear pinning.

Otoplasty is a surgical procedure that reduces the size, and in some cases reshapes the ears to make them more proportional to the face and head. It can be used to not only make large ears smaller, but it can also make ears that are too small the right size. It can also correct ears like the cupped, cauliflower, and the folded ones.

Here's how it works: A plastic surgeon will put the young child under general anesthesia (or under local anesthesia and a mild sedative if the child is older or a teen.) Then, during the next two to five hours, the surgery is performed as the cosmetic surgeon makes an incision in the natural fold between the back of the ear and the head. If the sensory organ size is to be reduced, the surgeon removes some of the cartilage and the skin. The remaining cartilage is then reshaped if necessary and the skin is sewn back into place at the original incision site.

There are very few risks involved with ear pinning, and recovery will generally include some degree of swelling, bruising, and tenderness. Bandages will be kept on the operated area for several days afterwards and the surgeon may even require the child to wear a headband for two weeks to keep the ears in the intended position. Pain medication can be used to manage any discomfort and the incision scar will be nicely hidden in the natural fold of the skin.

Because there are few risks and the recovery is not very intense, childhood is often the best time to have ear pinning done. Children's ears become fully grown anywhere from four to six years of age. Most surgeons will perform the surgery after that age threshold. Having the surgical process done earlier rather than later in life is smart because the cartilage is more pliable and shapeable in the younger years. The results are often more satisfying when the patients are children.

Of course, otoplasty also offers social and self-esteem benefits. Being constantly teased about one's disproportional body part can lead to feelings of low self-worth and depression in children and adolescents. In extreme cases, it can lead to introversion or unhealthy, aggressive behavior as self-defense mechanisms. Repairing the shape and proportion of this sense organ using the technique, can save kids from teasing and the consequential psychological effects. The child no longer feels embarrassed and will not be the constant scapegoat for tormentors' jokes.

Ear pinning surgery may be a cosmetic procedure but its product is much more. Children who undergo otoplasty have greater self confidence and happy lives as they grow into adulthood.

Getting Started

During consultation, your doctor will examine the structure of the ears and discuss possibilities for correcting the problems. Even if only one ear needs "pinning back," the surgery will probably be recommended on both to achieve the most natural, symmetrical appearance.

Otoplasty will not alter hearing ability. But with a successful procedure, the ears will be in proportion to the size and shape of the face and head.

The Procedure

The otoplasty procedure is performed in an outpatient medical surgery center, physician's office, or hospital. Surgeons typically suggest a general anesthesia for young patients and a local anesthetic combined with a mild sedative for older children and adults. For certain general anesthesia cases, an overnight hospital stay may be appropriate. Otherwise, patients return home within hours of the procedure on the same day. Under normal conditions, time for operation is about two hours.

Techniques vary among surgeons and patients. Factors that may impact the choice of technique include the general anatomy of the sense organ, the extent of the cartilage, excessive skin in the surrounding area, or level of deformity in other areas..

There are two common Otoplasty techniques:

* The surgeon first determines the incision location by finding the most inconspicuous site on the back of the ear. Once the incision is made, he or she will sculpt the exposed cartilage and re-position it closer to the head for a more natural-looking appearance. The surgeon may use non-removable stitches to help the cartilage maintain its position. In some cases, they will remove excessive cartilage in order to enhance the ultimate appearance.

* In the second common technique, skin is removed and the cartilage is folded back. There is no cartilage removed in this technique. Non-removable stitches are used to help the gristle maintain its position. Dissolvable or removable stitches are used for the incision location, which are removed or dissolved within seven days.

For total reconstruction, otherwise known as congenital microtia (ear absence), a common approach begins with developing a framework from the ribs, then elevating the back, and placing a skin graft. The ear canal is then carved out - often it is necessary to rotate the lobule. Ears that are malformed due to trauma (including burns) may undergo a variation of the reconstruction process, possibly with more extensive skin grafting, depending upon the extent of the tissue damage.

After Surgery

After the procedure, the head is wrapped with a thick bandage. Fitting of the bandage helps to maintain the new position and enhances the healing process. Patients usually return to the surgeon's office within the first few days to exchange the bandage for a lighter one. Your surgeon will provide specific instructions regarding the use of the lighter bandage and will also provide a complete postoperative instruction list, which you should follow carefully to reduce the risk of complications.

Young patients are often required to refrain from normal activity for at least seven days after the surgical process. Special care must be given to children throughout the first three weeks of recovery to restrict them from playful activities that may disrupt the hearing ability. Adult patients usually return to normal activity within three days after the surgical process. More complicated procedures may require a longer recovery time. In all cases, the sense organ should not be bent for at least a month or more.

During recovery, otoplasty patients may experience:

* Temporary discomfort and numbness - managed with oral medications

* Headaches - relieved through use of a long-acting local anesthetic

* Swelling - managed with head elevation, decreases within a week

* Unusual sensations - may include itching or the lack of sensation at the incision line, which can disappear over the course of six months.

Complications and Risks

Complications are possible with any plastic surgery, though they are rare with otoplasty. Complications can include a blood clot on the sensory organ or infection in the cartilage area. The surgeon may recommend a waiting period to see if the blood clot or infection (with antibiotic treatment) resolves itself. If the blood clot does not dissolve, it can be removed with a needle. Rarely, an infection may require surgical drainage. Scar tissue formation is a possibility. Many patients may have a slightly visible scar on the back of the ear. However, surgeons take special care to place the incision in an inconspicuous location.