Otoplasty — Ear Pinning

Otoplasty (ear pinning surgery) at MUDr. Šimek's Olomouc practice corrects prominent, protruding ears through cartilage reshaping and repositioning under local infiltration anaesthesia, with all incisions made on the back of the ear where resulting scars remain hidden. The correction is available for both children and adults — MUDr. Šimek's documentation emphasises the value of early correction in children to prevent social stigma before school age, while noting that adult otoplasty is equally effective and can be performed at any age. Bandages are worn for a minimum of 12 days, followed by a soft headband worn nightly for approximately one month.

Prominent ear deformity — otapostasis — is primarily a failure of the antihelix fold to develop normally during cartilage formation before birth, which allows the ear to project forward rather than lying flat against the skull. It is present from birth and does not resolve spontaneously. Correction by surgical otoplasty is effective, stable, and the incisions are placed in a position that renders scars clinically invisible. **MUDr. Šimek's technique** Access is through an incision on the posterior surface of the auricle (the back of the ear), which is hidden when the ears are viewed from the front, profile, or three-quarter angle. Through this incision, the anterior cartilage surface is approached directly. Concentric incisions in the cartilage create controlled weakening along the plane where the antihelix should fold — this allows the cartilage to be re-shaped into a normal profile. The new position is fixed through the scarring process rather than through sutures that hold tension permanently (a more stable long-term result). Modelling sutures are removed when the bandages come off (approximately day 12); the access incision sutures are removed two days later. **Children vs adult patients** The procedure is suitable for children from the age when the ear cartilage has reached approximately 85% of adult size — typically from 5–6 years. Correction at this age prevents the documented social and psychological impact of prominent ears during the school years. In the Czech Republic, the procedure may be eligible for health insurance coverage for children up to a certain age when medical indication is documented. Adult otoplasty is fully self-pay and equally effective — cartilage is somewhat stiffer in adults, which actually improves surgical predictability in some cases. **Anaesthesia** Local infiltration anaesthesia is used in the vast majority of cases, including for children in whom the clinic's assessment finds adequate cooperation. General anaesthesia is reserved for very young or anxious children who cannot remain still. This is an important practical consideration for families planning the procedure for school-age children. **Post-operative management** Bandages applied immediately post-procedure are worn for a minimum of 12 days — this duration reflects the time required for the cartilage to stabilise in its corrected position through the initial fibrotic healing phase. After bandage removal, a soft elastic headband is worn nightly for approximately one month to protect the ears during sleep (particularly to prevent acute angulation against a pillow). In cold weather, a hat or ear covering is recommended for several weeks. Complications — haematoma, infection, wound dehiscence — are uncommon with standard antibiotic cover and proper bandage care. **Realistic expectations** Otoplasty changes the relationship between the ear and the skull, creating a natural-looking lie against the head. The goal is symmetry and anatomical positioning rather than a specific aesthetic standard — MUDr. Šimek discusses target positioning with each patient at consultation using before-and-after reference images.