earStitch. safe, minimalist otoplasty

Technical details - earstitch otoplasty

In performing more than 100 otoplasty procedures a year Mr Greg O'Toole has adapted minimalist stitch based procedures {1-3} to be suitable for all shapes and sizes of ear, and all degrees of prominence. It can be used to for subtle corrections as desired, as well as to set back very prominent ears.

A natural appearance of the ears results from the careful placement of stitches allowing correction of prominence to a degree agreed before the procedure.

Mr O'Toole was persuaded to redefine the approach to prominence correction, as higher risk techniques using scratching, scoring or cutting the cartilage are still prevalent around the world. "Incisionless" techniques on the other hand, have a higher rate of recurrence of prominence. EarFold and EarStitch have evolved to balance these risks.

The earStitch procedure is highly versatile. A short incision is made on the back of the ear and any of four different stitch placements are used depending on the precise correction required. The four stitches are defined as, the Top Stitch, the Bowl Stitch, the Fold stitch and the Lobe Stitch.

The Top Stitch

The Top Stitch {1} addresses the uppermost part of the ear. Some ears stick out only at the top with the rest of the ear being completely normal. In these cases a full otoplasty (ear pinning, pinnaplasty) is not necessary. The Anchor stitch draws the top of the ear closer to the head, as much as is desired without affecting the rest of the ear. A 1 cm incision on the back of the ear is all that is required. It can of course, be combined with any of the other stitch placements described below. 

The Fold Stitch

The Fold Stitch {2} addresses the anti-helical fold of the ear, in a similar way to an earFold device. The fold of the ear is sometimes too soft and this causes ear prominence. The fold stitch tightens the anti-helical fold from behind with a few stitches through a small incision, usually around 2 cm in length.

The Bowl Stitch

The other common cause of ear prominence is the presence of a deep conchal bowl. The bowl stitch {3} rolls back the conchal bowl, without the need for the removal of any cartilage, through an incision of around 1cm.

The Lobe Stitch

A prominent earlobe is sometimes a feature of an otherwise normal ear. Normally however, earlobe prominence forms part of a more generalised prominence of the entire ear. A delicately placed suture between the tail of the helical rim and the back of the conchal bowl corrects lobe prominence effectively. On its own, the lobe stitch needs only a very short incision on the back of the ear.

The consultation and procedure

earStitch is a generic term for any combination of the above approaches to prominence. A full discussion as to which approach(es) to use would be held in an out-patient clinic consultation, prior to a date for the procedure being arranged. On the day itself, photos would be taken and measurements of the desired final position of the ears would be made so that the final results can be very precise. 


{2} Mustarde J C. The correction of prominent ears using simple mattress sutures. Br J Plast Surg.


{3} Furnas D W. Correction of prominent ears by conchamastoid sutures. Plast Reconstr Surg. 1968;42(3):189–193

earStitch Testimonials



by Vicki Thurs Nov 02, 2016  

I first went to see Mr O' Toole in July this year, with  regard to a prominent right ear correction. Almost 3 months to the day later I had my earstitch procedure and I can honestly say I have received nothing but exceptional care and treatment from Mr O' Toole and can highly recommend him if you are considering ear surgery.

Since the age of 13, I first became hugely self conscious and increasingly aware that my right ear was more prominent than my left. For the next 20 years it really bothered me, I covered that ear with my hair at all times, avoided photos and was desperate to have otoplasty. What may have seemed trivial to most hugely affected my confidence, already being self conscious of how I looked anyway, the ear was the one thing I could try to improve! However , being  very squeamish and a wimp  when it comes to pain the "old style" method and need for a GA horrified me. Quite by chance, I came across an article in a newspaper about the new pioneering earfold method, I was instantly intrigued and fascinated and immediately searched this procedure online, doing a huge amount of reading and research having never heard of it before. The minimalistic approach with a rapid return to work etc really appealed to me so in May 2015 I tentatively emailed Mr O' Toole's team but at that stage was just too nervous and hesitant to take it any further. I spent the next year or so continuing to read countless patient reviews and thought it sounded everything I had ever hoped for and more.. I knew deep down I still desperately wanted this done and would always regret it if I never proceeded further, so in July I emailed again and booked my initial consultation, knowing that if I didn't do it now I never would.  

The hardest part for me and the biggest step to take was this initial consultation, I wondered "what was I thinking?!", I was so unsure, nervous and uncertain of what to expect, having never had any procedure or surgery  before. On the day I was so nervous I could hardly speak! Mr O' Toole straight away put me at ease, was very welcoming, friendly and approachable, almost instantly my anxiety disappeared and although I felt embarrassed and reluctant to show him my ear, he understood it is a sensitive subject and nothing to be self conscious about. He carefully explained exactly what both earfold and earstitch involved, clearly stating what can and cannot be achieved by each method, and made it very clear the risks of possible post op complications, the expected recovery time, chances of recurrence and the cost. He also fully answered my questions then asked me what I would like my ear to look like, and got me to show him in a mirror, he listened to how I felt, valuing my opinion and expectations. I personally wasn't keen on the earfold , preferring instead the idea of the stitch method, to which Mr O' Toole agreed but said we could try on an earfold anyway just to see what result it would have for me, it overcorrected my ear confirming the stitch would work best. Mr O' Toole showed and talked me through  a "touch surgery" computer generated simulation, which was absolutely brilliant in showing me exactly how this surgery works , this was extremely useful to me, helping me to understand the procedure fully to get a realistic idea of what it involved surgically. I walked out elated, impressed by  everything I had heard and so glad that I went, any doubts I had earlier had faded away , and he had installed confidence  in what he could offer- I knew now for certain this was a realistic option to me.  

I was advised to go and spend time thinking  carefully about this decision, and a week later decided I definitely wanted to go ahead, so it was booked for October, I eagerly anticipated the day and couldn't wait to get it done. On the day of surgery, Mr O' Toole again explained clearly and concisely what to expect. Everything went amazingly well, I was actually excited and it was far , far better than I ever imagined, I anticipated it to be a very painful, scary experience but in fact it was very pleasant and strangely enjoyable! This was largely thanks to the fact that during surgery Mr O' Toole remained calm, highly focussed yet still able to put you at ease, along with the fantastic operating theatre team at the Platinum Medical Centre, who very extremely kind, caring, friendly and reassured me hugely by explaining exactly what was happening and why,and  what to expect at every step of the procedure, even making me smile! Without their expertise, professionalism  and empathy I would have been very fearful and found the surgery far more daunting. All of the nursing staff also provided a wonderful degree of care, courtesy and kindness which again made the whole day so much easier and relaxed, at all times you felt so safe, well cared for and constantly reassured.  

During and after the procedure I felt no pain, I had prepared myself for weeks if not longer of awful pain!, I experienced what I would describe as throbbing and discomfort rather than pain for around 4 hours the evening of my surgery, it was bearable and 2 paracetomol soon sorted this , there was no further pain at all, by day 4 the swelling and bruising had virtually disappeared and all appears to be healing very well so far. At my day 3 post op check I once again found Mr O' Toole to be polite, kind, down to earth and keen to ensure I was happy so far. Again, he explained everything very clearly to me, answered my questions, and promised that if I have any recurrence in future or am not happy once we see the final position of my ear, I can return to him. He genuinely wants his patients to leave happy and satisfied and achieve the very best possible results that he is able to, I again felt very reassured and confident , knowing I can return should I need to and not be at all worried or reluctant to do so, which is a relief.  

It is still early days yet as I still have some glue attached  and stitch removal in 2 weeks, so we won't know the final result for some time, but I am already delighted and amazed at the improvement and difference, giving me a huge boost already and just being able to walk out the day of the  surgery with my hair up for the first time in 20 years felt great!. Mr O' Toole is  honest, realistic and makes sure you are fully aware of the chance of recurrence but he ensures you would feel happy and able to return to him which really puts your mind at ease.  

Right from my initial enquiry I have also found Mr O' Toole's secretary to be very helpful , polite and made sure it all went very smoothly, emails were replied to promptly, all of my questions were answered and I was kept fully up to date on appointments and all aspects of booking which has made it so easy and straightforward for me and would like to say thank you for.  

I don't think I knew what to expect but the whole experience has been a very  positive one, and a pleasant surprise just how well it has gone so far, all of my initial fears and worries soon disappeared, I felt sure I had chosen the best surgeon,   a very highly skilled, competent  and experienced man who cares about the patient and their expectations first and foremost. I was overwhelmed and quite emotional by the amount of kindness, and excellent care I received throughout, I knew I had no reason to be worried and would especially recommend Mr O' Toole and his team if you are very nervous, self conscious or unsure as his gentle yet knowledgeable manner instantly puts you at ease.  

I will be forever grateful and thankful to Mr O' Toole and his team for everything they have done for me , I am so  impressed with the results so far, after having waited for so long for something I never thought was possible for me it means the world to me that it went so well and is  a huge relief to have achieved this at long last!, I definitely made the right choice and without doubt one of the best decisions I have ever made , I  can't thank everyone enough!    

by SC July 2018 ​ Hello, I just wanted to send a quick email to thank Mr O'Toole. It's been a year since my ear surgery and all is well. Thank you for your excellent service and the professionalism of your team. I'd certainly recommend you.  

Warm Regards, 

Hi Greg,  

I’d just like to say how impressed and pleased I am with my results. Initially, I thought they were not pushed back enough but now it has been nearly two months and they are just perfect. If they were pushed back more they would be invisible from front on! You would never even have noticed that I had work done on them. They’ve healed very well and my confidence is higher than ever. Im 100% certain I made the right choice going to you for my surgery. Its worth paying that little bit extra for higher chances of it being the outcome I would have only dreamed of having. Your attention to detail and the care that goes into your surgery is outstanding. Many doctors would go too far and glue the ears back to the head without thinking of how they will look in the long run. But you executed the surgery perfectly!  

The whole process was very professional and well handled. You were super atentive and helpful, especially where I (as I’m sure most others do too) panicked at the first sign of asymmetric pain and blistering! My fear of needles close to my face was handled amazingly by you and your fabulous nurse, both of which kept me entertained and distracted throughout the whole surgery. Although I must say I don’t think I’d like to go through it again, I’m glad that you and your nurse were the ones helping me through it!  

I could not recommend you and your high skill set enough and thank you for completely changing my life and confidence, as silly as that sounds. I have not worn my hair down since the procedure and that is all thanks to you! Your secretary was very helpful and understanding with changing the date of the surgery to suit my payment issues and answered all of my questions perfectly.  

Even my mum was impressed with you and your team and she wasn’t keen on me having surgery in the first place! Thats saying something. My agency are also very happy with my results and agree they look very natural and perfect.  

Thank you again and I hope they continue to heal and look as amazing as they do now.  

I will definitely be recommending you to anyone that wants to hear it.

Thanks again Greg 

by Most30 Sun May 20, 2012   

Absolute gentleman. Fantastic surgeon. Great team.  

I could not recommend Dr O'toole highly enough to anyone considerIng ear surgery. I am extremely happy with the results of my prominence ear correction in March 2012, thanks to Dr O'toole. I can honestly say that it has changed my life and looks better as each day goes by. 

by Stephanie January 2014  

I would like to share my positive experience with Mr O'Toole. >  

> After going to see Mr O'Toole in April 2013 for an initial consultation for prominent ear correction, I made the decision to go ahead with the procedure and had my first prominent ear correction surgery in June 2013. I had always wanted to get it done at some point through my teenage years but was quite scared as to what it would involve and did not know what surgeon to go to or which one to trust. >  

> After researching various surgeons again when I was approaching 30 I came across Mr O'Toole and noticed he had a lot of positive reviews. This is one of the reasons why I chose to book a consultation with him. After the consultation I was definate that I wanted to go through with the surgery. Mr O'Toole spent a lot of time with me explaining the procedure and the possible outcomes. Mr O'Toole advised me about the risks of which recurrence was one. He said that this happened in every 1 out of 10 cases. Mr O'Toole reassured me and was very down to earth and honest with whatever questions I had asked. He was also confident that he could improve the look of my ears. >  

> After my first surgery in June 2013 I went back for a few follow up appointments. It took around 4 months for the final position of my ears to be noticed. I went back to Mr O'Toole in November (5 months after surgery) as I had noticed that my right ear had moved back out more than the left (left had only moved slightly). He agreed that my ears had moved and offered to re-operate on my ears free of charge to correct this. This was arranged for January 2014. >  

> I am now 3 weeks post the second procedure and again everything went well. I will again have to wait to see the true position of my ears after around 3 to 6 months, however I am confident that he has achieved a good result. If not, I feel completely comfortable to go back to him and discuss this. >  

> Overall, I have found Mr O'Toole to be a nice guy, who genuinely cares and wants his patients to be happy with the results. If anyone is thinking about prominent ear correction I would definitely recommend Mr O'Toole. 

by AreanJ Wed Jan 09, 2013   

I came across Dr. Greg O'toole and I have to say I will forever be grateful. I made the decision this summer (August) to correct the prominence in my left ear. 

From the first day he was very professional, kind and had a genuine interest in what I had to say. Now 2 months after my operation, there is no visible scar and my ear is healing beautifully.  

All in all I would thoroughly recommend Dr.O'toole.