Otoplasty
Conveniently located to serve Dallas and Plano, TX
What is Otoplasty (Ear Pinning)?
Otoplasty describes cosmetic ear pinning in which a prominent ear is brought back closer to the head.
Who is a Good Candidate for Otoplasty?
There are two basic types of prominent ear deformities: cup ear and lop ear. A cup ear describes a conchal bowl that is too large, and a lop ear describes an ear missing a well-defined antihelical fold. At times an individual may have both problems to varying degrees. In addition, there may be a prominent ear lobe that would benefit from a simultaneous reduction. Dr. Lam is very skilled at otoplasty performing this procedure more frequently than most surgeons and has handled all types of ear deformities including helical rim deformities, partially missing ears, and other ear problems. However, he does not perform microtia repairs, which refers to children born without ears or with very underdeveloped ears.

Types of Ear Deformities
Cup Ear
A cup ear describes a prominent conchal bowl. The concha is the rounded cup-like cartilage in the middle of the ear near the entrance to the ear canal. If the concha is very large, then the ear can protrude outward and resemble a cup in shape. Many surgeons advocate simply pinning the conchal bowl back to the head. Dr. Lam believes this simply does not work well. When there is too much cartilage, it must be reduced or the ear will not naturally bend backward. In addition, the degree of reduction will not remain where it needs to be if the cartilage is not reduced. Fortunately, reduction of the conchal cartilage can be performed with the incision well-hidden inside the lip of the conchal-bowl edge and provides reliable and accurate reduction.
Lop Ear
A lop ear describes the partial or complete absence of the antihelix, a normal fold inside the outer helical rim typically shaped like a Y. With a weak or absent antihelical fold, the ear lops (or falls) over. A lop ear is reduced using Mustarde sutures that recreate the antihelical fold. The biggest problem with Mustarde sutures is that they can be prone to relapse or loss of fold. Dr. Lam uses a technique that significantly minimizes this occurrence. Many surgeons make cuts on the back of the ear cartilage. The problem with this technique is that even though it weakens the cartilage it makes the ear want to bend in the wrong direction. Weakening of the ear cartilage with through-and-through cartilage cuts risks the visibility of the cut cartilage, which is unacceptable. Similarly, scoring techniques in the front of the ear can show up as visible irregularities. Instead, Dr. Lam uses a specialized rasp that files down the anterior cartilage uniformly that achieves multiple benefits without the risks. First, the ear cartilage can be significantly weakened to minimize recoil, and Dr. Lam can adjust the degree to which he files the cartilage based on how strong the tendency to recoil is. Second, the reduction of the anterior perichondrium (lining of the cartilage) helps to ensure the ear does not recoil since it encourages the ear to bend farther in the proper direction rather than in the wrong direction. Finally, Dr. Lam also simultaneously relaxes the conchal bowl as described above for cup ears but without typically removing cartilage in these cases. Dr. Lam believes the more relaxed the ear can be without making incisions where visible cartilage could be observed is the key to attaining consistent long-term outcomes.
Many individuals have both problems (cup and lop ear) along with an enlarged or prominent lobule. There are many ways to reduce a lobule. The most reliable method to reduce the lobule is to secure the cauda helicis (the very bottom part of the ear cartilage to the concha). This brings back the lobule and sets it in a good position. The lobule may also be set back using a V-Y advancement but Dr. Lam uses this method only as a supplement to cauda helicis repositioning. Rarely, the ear lobe can be further made smaller through a wedge reduction along the crease where the ear joins the face.

What are the Priorities for an Otoplasty Procedure?
It is important to think of the priorities for each otoplasty procedure performed in Dallas, Texas. The main priority is to help make the ears appear relatively symmetric from the frontal view, i.e., the degree to which they are projecting from the head. When ears are asymmetric, it is nearly impossible to make them perfectly symmetric and there can be a tendency to return toward some degree of pre-existing asymmetry. However, Dr. Lam works hard to ensure frontal-view symmetry. When an asymmetric ear is pinned farther back, the antihelix can appear more prominent and fold slightly differently from the other ear simply because that ear has more cartilage that may be causing the asymmetry. Accordingly, when that ear is brought back to match the other ear in terms of the degree of projection of the head, the more prominent ear may have a slightly different shape. Dr. Lam prioritizes the degree of projection of the head as the number one priority to achieve but if the ear bends too differently, he uses his aesthetic judgment to balance these concepts for the most natural and attractive outcomes.
How is Otoplasty Performed?
The procedure is performed under light IV sedation to make the procedure very easy to tolerate with no discomfort. All procedures are performed in Dr. Lam’s accredited surgical facility for patients who are 18 years of age or older. For younger patients, especially young children, Dr. Lam performs the procedure under general anesthesia in the hospital at Texas Health Presbyterian Hospital of Plano about 2 blocks away from Dr. Lam’s office. All procedures are outpatient-based, meaning you go home the day of the procedure but you must have a companion drive you home. The procedure typically takes about 90 minutes to perform and you will wear a large wrap around your head for one night.
Dr. Lam’s Approach to Otoplasty
Dr. Lam has published his approach to a balanced otoplasty in which the top, middle, and bottom thirds are proportionally reduced. Too often on websites, you see an over-pinched middle portion of the ear, which leads to a surgical complication known as a telephone deformity. Conversely, you may see the upper third of the ear overpinned called a reverse telephone deformity. In addition, you may see the bottom third of the ear not properly reduced leading to an exaggerated ear-lobe appearance. Finally, the helix may be completely hidden, which is both unnatural and unattractive. Dr. Lam has a very good aesthetic sense to make ears appear both natural and attractive.
What are the Risks with Otoplasty Surgery?
The biggest problem with otoplasty is the tendency for the ear to relax over time. Dr. Lam has a very low occurrence of this problem for all the reasons enumerated above. It is important that even though he rarely experiences a full relapse of an ear that there can be a few degrees of relaxation in a percentage of his patients. Dr. Lam can achieve very accurate reductions but you should allow for minor degrees of relaxation.
What is the Recovery Period?
The first night can be uncomfortable and Dr. Lam recommends taking the prescribed narcotic medications before you go to sleep. He uses a long-lasting injected anesthetic that begins to fade the first night and needs to be supplemented with oral medication. You return to the office the following day to remove the large conforming head dressing and the drains. A lighter athletic headband should be purchased to be placed when the head dressing is removed. Dr. Lam will advise you about this and show you how to place it on your head. You will need to wear this headband 24/7 for the first week and only when you sleep for the first 6 weeks. There can be some minor drainage after the drains are removed for a day or so and that is normal. The ears will look engorged and bruised the first week but aesthetically they will be covered with the headband. There can still be some residual swelling and bruising into the second week. Most people take a week off from work. During the first 1 to 4 days the ears can be very tender and sore, and this again is normal. The tenderness may persist even beyond the first week or for a few weeks, but the greater tenderness that is present for the first few days should diminish rapidly.

What are the Benefits of Otoplasty?
Of course, otoplasty surgery in Dallas, Texas does not provide any physical benefits but offers only purely psychological rewards in terms of how you feel about yourself. Oftentimes, adults choose to have an otoplasty because they were teased as a child about their ears or simply because they were always bothered by them but never dared do the procedure earlier. Children come to Dr. Lam because they are bothered by other children and decided to get something done about it before the psychological damage sets in. Interestingly, the vast majority of Dr. Lam’s patients are adults deciding to undertake this procedure later in life. Besides added confidence in how you look, an otoplasty can also provide a much more balanced result to the face making you subtly or dramatically more attractive. Like a good rhinoplasty, a good otoplasty goes undetected and just makes an individual more aesthetically attractive overall.
What are the Costs of Otoplasty?
Dr. Lam believes he charges a very reasonable price for the level of artistry and experience that he brings to you. If you are an adult performing this procedure, the cost can be lower than for a child who needs to have the procedure oftentimes performed in a hospital setting. For up-to-date and accurate pricing, please call Dr. Lam’s office and his staff will help give you an estimate before you come in for a consultation with him.
Contact Our Office
All otoplasty surgeries are performed by Dr. Lam himself, at his Cosmetic Surgery center in Dallas Texas. To schedule an otoplasty consultation call 972.312.8105 or email us . The details of your otoplasty procedure (both the limitations and the benefits in your particular situation) will be explained to you during your consultation with Dr. Lam and his team.
Your Otoplasty will be performed by Dr. Lam' surgery center located in Plano, TX.
Otoplasty FAQ’s
What precautions should I take after the ear procedure?
What’s the youngest age that Dr. Lam can perform a procedure?
Does Dr. Lam accept insurance for ear pinning?
If my ears are asymmetric, can Dr. Lam fix that problem?
Can he make my ears actually smaller in size?
Can he fix my torn earlobe?

Can he make my ears look younger?
Your Otoplasty will be performed by Dr. Lam' surgery center located in Plano, TX.
I highly recommend Dr. Lam. He is a perfectionist and took the time to listen to my concerns and explain the procedure in detail. His staff has always been warm and welcoming from the day of my consultation, throughout the procedure and follow up appointments. I am very happy with the results of my procedure! Thank you Dr. Lam!
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To schedule a otoplasty consultation call 1-888-866-3388 or email us. The details of your otoplasty (both the limitations and the benefits in your particular situation) will be explained to you during your otoplasty consultation with Dr. Lam and his team.
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