Which first? Ear reduction or ear pinning
A number of patients have ears which are both large and which stick out. For these ears, surgery to set back the ears and to reduce their size may be required. Some combinations of set back of the ears and ear reduction are possible at the same procedure. Others, because of possible compromise of blood supply, are not.
If two procedures are likely to be required, then it is recommended that it is best to tackle the element of an ear problem which upsets you most, in the hope that a single surgery alone might suffice.
Set back of the ears can be combined with ear lobe reduction, for example, but ear set back and ear reduction at the upper pole should not be performed at the same time. An upper pole ear reduction can also slightly set in the upper pole of the ear by a few millimetres, if requested. It is generally best, therefore, to reduce the size of the ears first, and to proceed to a further separate surgery to set back the ears only if your confidence is not sufficiently restored.
Although it is possible to set back the ears first, and then reduce them in size at a later date, this surgery is more difficult, since the set back surgery tethers the ears to the side of the head and so the amount by which they can be made smaller can be restricted.
The interval between upper pole ear reduction surgery and set back surgery, if required, should be at least three months.