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Macrotia Versus Ear Pinning

So what is the difference between macrotia ear reduction surgery and traditional otoplasty ear pinning? It is worth differentiating between these two procedures as many macrotia patients consult with me with the notion they need to have their ears pinned back.

Scapha Reduction Surgery

Macrotia surgery is targeted at reducing the size of the scapha. Learn more about the scapha by reading here. This may or may not bring the top of the ear in closer to the head – but it is not an attempt to pin the ear back closer to the side of head. Rather, the main goal of reducing the scapha is to create a smaller ear in terms of the vertical and horizontal dimensions. You can visually see the concept of macrotia ear reduction in the adjacent photo diagram where the arrows indicate how the ear will be reduced in overall size. This is typically accomplished by making incisions along the front side of the ear and resection (removing) the excess cartilage and skin. Once the ear is put back together, it has a shorter vertical dimension and a more narrow horizontal dimension.

In most patients who have an enlarged scapha, the ear does not necessarily stick out too far from the side of the head. So traditional otoplasty surgery that involves bringing the ear closer in to the scalp surface would not directly address the anatomical problem. What is really needed is an operation geared towards making the ear smaller in size by reducing the scapha as noted above.

Traditional Otoplasty Pinning

In traditional otoplasty patients, the ear is pinned back closer to the surface of the scalp in order to make the ear look less prominent. Although traditional ear pinning does involve cutting out some cartilage, it is a much different type of cartilage reduction. Traditional otoplasty technique that involves cartilage reduction is usually isolated to the conchal bowl and is done from behind the ear. Plus, the goal of taking cartilage out for ear pinning is to make it easier to keep the ear pinned back in position – not to make the ear ‘smaller’ in size. Additionally, ear pinning does not make any real adjustment to the vertical and horizontal dimensions of the ear. So although traditional otoplasty ear pinning does make the ear less prominent, it does not really reduce the size of the ear. Macrotia surgery makes the ear less prominent while also making it smaller in size.


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