Drs. Burton Sundin and Reps Sundin perform otoplasty for children at Virginia Institute of Plastic Surgery (VIPS) in Richmond. If you are considering this procedure for your child, here’s how they evaluate candidacy, what age is appropriate, and what families should expect.
Otoplasty for Children in Richmond: The Right Age, the Right Questions, and How Drs. Sundin Approach Pediatric Ear Surgery
Ear surgery for children is one of the more delicate decisions a family can navigate in the world of plastic surgery. The concerns are real, the emotional stakes are high, and the questions parents have are often different from the ones adults bring to a cosmetic surgery consultation.
At the Virginia Institute of Plastic Surgery in Richmond, Drs. Burton and Reps Sundin approach pediatric ear surgery with the same combination of technical precision and thoughtful patient care they bring to every procedure. Here’s what families in Richmond need to know before that first conversation: appropriate age, how candidacy is evaluated, what the procedure involves, and what recovery looks like for a child.
What Otoplasty Addresses
Otoplasty, also called ear pinning or ear reshaping surgery, is most commonly performed to correct ears that protrude prominently from the sides of the head. The degree to which ears protrude varies, and so does the degree to which it affects a child's daily life.
Beyond protrusion, otoplasty can also address ears that differ significantly in size or shape, ears with an absent or underdeveloped antihelical fold (the curved ridge of cartilage that gives the ear its shape), and ears with an overly large or prominent concha (the bowl-shaped depression at the center of the ear).
The goal in every case is to bring the ears into a more balanced, proportionate relationship with the rest of the face and head, without creating an unnaturally flat or overdone appearance.
What Is the Right Age for Otoplasty?
Age is one of the most common questions parents ask, and it is also one of the most important. Drs. Sundin look at two factors: physical maturity and emotional readiness.
Physical Maturity of the Ear
The ear reaches approximately 85 to 90 percent of its adult size by age five or six. This is significant because it means surgery performed after this age will not need to be revised as the ear continues to grow. For this reason, most plastic surgeons, including the Sundins, consider age five or six the earliest appropriate window for otoplasty in most children.
Many families choose to proceed before the child begins school, recognizing that teasing and social awareness of appearance increase significantly in the school years. Others choose to wait until the child is older and can participate more actively in the decision.
Emotional Readiness
Our providers take the child's perspective seriously in every pediatric consultation. A child who does not understand the procedure, is frightened, or does not want surgery is not a good candidate, regardless of physical readiness. Drs. Sundin look for children who can communicate their own awareness of their ears, express some desire for change, and demonstrate the maturity to participate in basic instructions around recovery.
There is no upper age limit for otoplasty. Teenagers and adults undergo the procedure regularly at VIPS with equally excellent outcomes.
How We Evaluate a Pediatric Patient
The consultation for a child at VIPS includes the child's parents or guardians and, whenever possible, the child themselves. Drs. Sundin begin by examining the ear anatomy carefully: the degree of protrusion measured in millimeters from the side of the head, the presence and quality of the antihelical fold, the concha depth, and the earlobe position.
They also listen. What does the family describe as the concern? Has the child expressed awareness or distress about their ears? Is the motivation coming from the child, the parents, or both? These are questions with real bearing on whether and when surgery is appropriate.
Drs. Sundin will discuss the surgical plan, what can and cannot be achieved, realistic expectations for the result, and what recovery involves for a child specifically. Parents leave the consultation with a clear understanding of the procedure and what it means for their child before any decisions are made.
Questions Parents Should Ask During the Consultation
Families preparing for a consultation about pediatric otoplasty often find it helpful to come with specific questions in mind. Some of the most useful ones to ask include:
- Is the degree of protrusion significant enough to warrant surgery, or is watchful waiting appropriate?
- What surgical technique will be used, and why is it the right choice for my child's anatomy?
- What are the realistic risks and potential complications specific to pediatric patients?
- How will my child's pain be managed during and after the procedure?
- What activity restrictions will apply, and how will we manage them with a young child?
- What does the scar look like, and where will it be located?
- What happens if one ear heals differently from the other?
Drs. Sundin welcome these questions and consider a thorough back-and-forth during the consultation to be a sign of an engaged, well-prepared family rather than an imposition. The more clearly parents understand the procedure, the better the experience tends to be for the child.
How Otoplasty Is Performed at VIPS
For younger children, otoplasty at VIPS is typically performed under general anesthesia to ensure the child remains comfortable and still throughout the procedure. Older children and teenagers may be candidates for the procedure under local anesthesia with sedation, depending on their maturity and comfort level.
The surgery itself involves incisions hidden in the natural crease behind the ear, through which Drs. Sundin reshape and reposition the cartilage. The antihelical fold is created or reinforced using sutures, and the ear is brought into a position that achieves the desired correction while maintaining natural contour and proportion.
The incisions are closed, and the ears are wrapped in a protective bandage that is worn for the first week. Because the incisions are placed behind the ear, scars are effectively invisible once healed.
What Recovery Looks Like for a Child
Recovery from otoplasty in a child is generally well tolerated, though it does require some management and planning.
Week 1: The ears are bandaged. Swelling and mild discomfort are expected and managed with appropriate pain medication. Children are typically restricted from physical activity, bending over, and anything that might put pressure on the ears.
Weeks 2 to 4: The bandages are replaced by a lighter headband that the child wears at night. This protects the ears during sleep while the cartilage continues to settle. Most children return to school within one to two weeks.
Month 2 and beyond: Activity restrictions are gradually lifted. Final results become fully visible as swelling resolves completely, typically within two to three months.
One of the practical considerations for pediatric otoplasty recovery is ensuring that younger children understand and follow the activity restrictions. Parents play an important role in this, and the VIPS team provides detailed guidance to support the process.
Long-Term Results and Satisfaction
Otoplasty produces a permanent correction. The ears do not revert to their pre-surgical position once the cartilage has healed in its new shape. Results are visible immediately after bandage removal and settle into their final form over the following months.
Patient and family satisfaction following pediatric otoplasty is consistently high. For children who have experienced teasing or self-consciousness related to their ears, the psychological benefit of the procedure often extends well beyond the physical result.
Scheduling a Consultation at VIPS in Richmond
If your child has prominent or asymmetric ears and you are considering whether otoplasty is appropriate, Drs. Burton and Reps Sundin welcome families to schedule a consultation at the Virginia Institute of Plastic Surgery. With more than 30 years of combined experience in facial surgery and a thoughtful, patient-centered approach to pediatric care, VIPS is where Richmond families bring their most personal decisions.
Contact our Richmond office to schedule your consultation today.
