Dr. Merck’s stitch method – the new alternative Otoplasty (Pinnaplasty, Ear pinning, Ear Pinback, Ear plastic surgery; Correction of prominent ears, Protruding ears, Bat ears, Sticking-out ears)

(You can find additional information in our ears forum, especially about the differences between the "Incisionsless otoplasty" by Dr. Fritsch and the Merck method)

We operate according to a method developed by Dr. Merck- with the “Dr. Merck's stitch method”, a new modern minimally invasive otoplasty procedure with short recovery times and without head bandages.

Dr. Merck himself and a team of qualified doctors, personally selected and trained by him, perform this new, alternative otoplasty.

Dr. Merck is a specialist in ENT (Ear-Nose-Throat) and plastic surgery procedures. Up until June 30, 2003, he was Director of the Department for ENT and Plastic Surgery at the Konstanz Clinic in Germany. Due to the continuously great demand for otoplasty procedures using his new innovative stitch method, Dr. Merck decided to devote himself entirely to these procedures.

Dr. Merck has been practising his alternative new stitch method since 1995, first announcing it publicly in the year 1999. Since then, it has been widely accepted by his patients and the media ( see Press Reviews ). In the meantime, he has successfully corrected more than 8000 ears with his new otoplasty, a number that no other doctor in the world can match.

While most doctors and cosmetic surgery clinics offer ear correction as a “side offer” in addition to other surgeries such as face-lifts, breast corrections, and liposuction, Dr. Merck’s ear clinics in Contance, Majorca and Tenerife specialise in otoplasty procedures only, carrying them out according to the “Dr. Merck stitch method”. This specialization guarantees the patient safe treatment and optimal operation results.

With the Merck method, non-absorbable Prolene threads are sunk invisibly under the skin using small stitches. With these stitches, a fold of the auricle, called the antihelix, is bent more strongly or reshaped into its natural form and the protruding ear falls automatically into the correct position. If the anatomy of the ear requires it, the same technique can be applied to the correcting of a large conchal bowl ( Cavum conchae ) – this is the the bowl-shaped cavity just outside the opening of the ear canal - by moving the antihelix fold in the direction of the ear canal entrance ( called medialisation of the antihelix ), thus reducing the large cavum conchae and moving the ear closer to the head in the process. The only wounds are tiny stitch-points on both sides of the ear that heal after a few days and are no longer visible after that. The patient can see the result already at the end of the operation. As no more cutting is involved, there are (in contrast to the usual methods) no scars left on the ear. Beautiful, particularly natural-looking auricles can be formed this way. With the Dr. Merck method, and in contrast to the traditional methods, it is impossible to tell that the ear once protruded and has been corrected. All the usual signs of an operation are missing. The patient also spares him- or herself the usual risks of the traditional operative methods, which include danger of infection, effusions of blood, lasting pain and bandages, cosmetically unsatisfactory results with depressions, uneven surfaces, and unnatural formations of the auricle.

There are only a few, non-dangerous, and rarely occurring risks associated with Dr Merck’s Stitch Method. These include the possibility of a thread intolerability with thread rejection. In rare cases the ears may protrude again by a few millimetres or more. To prevent infection, rejected threads must be removed, which is a quick and simple procedure. A re-protruding ear can be corrected as simply and minimally invasively as at the first operation. The charge for a necessary re-correction is only a fraction of the costs incurring for materials, operation room and personnel. This is currently calculated at 180 euro if carried out in Constance. In Tenerife and Majorca there are additional costs for the hire of the operation room that must be paid for; these are 200 euros in Tenerife and 240 euros in Majorca. There is no charge for the surgeon.

The procedure is performed on an outpatient basis. For children younger than 11, the procedure is performed under general anaesthesia. On children older than 12 and adults, local anaesthesia is used. If children want the procedure themselves, an operation under local anaesthesia is also possible earlier.

For children, it is best to have this operation before they start school. It is, however, possible to have the operation at any age. The oldest male patient so far was 86, the oldest female patient was 74. With this method, nearly any protruding ear, regardless of the thickness of the cartilage or the size of the ear, can be corrected.

A true innovation is that during the operation, every patient may not only check but also actually help determine the position of his or her ears using a hand-held mirror. The patient goes home immediately after the operation, without bandages.

Children can go to school and adults can go back to work the next day. With the Merck method neither a bandage nor follow-up treatment nor monitoring by a doctor is necessary.

People who have ears which not only protrude but are also extremely large sometimes ask that the size of their ears be reduced in the same session as the otoplasty. It has become clear, however, that such a reduction is not necessary because a corrected protruding ear appears to be much smaller.

With Dr. Merck`s stitch method, every protruding ear (and also often protruding earlobes) can be treated.

There are some doctors in Germany using the term "stitch method" on the Internet despite the fact that they do not operate according to the Dr. Merck new alternative stitch method. Please make sure that your operation is according to the Dr. Merck method or, if in doubt, contact us directly.

The Merck method is also not the "Incisionless otoplasty" by Fritsch. For further details about the differences between the Stitch method and the method by Fritsch, look in this ear-forum on the page: "Dr. Merck´s stitch method"

Sometimes, our patients tell us that other doctors advise them against having an operation with the stitch method. This is because these doctors are not familiar with the method and cannot imagine it working. The great number of ears operated on by us in the meantime proves that they are incorrect in their assumptions. If the method did not work, we would not have been able to operate on more than 8000 protruding ears to date. That is a number that no other doctor or clinic in the world has achieved till now.

Our surgeons are the first in the world that can present long-term results over a time period of 17 years, that are also based on a very large number of operations – a number that has not been attained before. This covers 5528 ears that we operated on between 1996 and 2008. We have not included the operations carried out after this time in these studies, because we did not want to falsify the results due to a too short postoperative observation period ( for the results, please click on the comparison table here). In comparison, the very big University ENT Clinic in Freiburg i.Breisgau carried out a total of 109 ear correction operations in four and a half years, from 1970 to the middle of 1974, i.e. an average of 25 per year. A corresponding publication by this clinic about its achieved results only covers an observation period of four years ( Martin, 1976). Additionally, all the other publications known to us that report about results of ear correction operations, always cover only short time periods of up to a maximum of 5 year.

Summary of the advantages of the Merck Stitch Method compared to the usual traditional methods used to date:

Optimal cosmetic result, with formation of a round, edge-free antihelix (natural auricle fold)
Using a hand-held mirror, patients help determine the position of their ears during the operation
No head bandages
No cutting of the skin. Per ear, only a few small stitch incisions on the back side of the auricle
No cartilage reshaping or removal, no skin removal
No scars
Practically no blood loss
Extremely low risk of infection
No pain during the operation
Only short-term pain after the procedure
Great acceptance on the part of patients (oldest patient was 86)
Short-term antibiotic treatment of one to three days
No or only short-term need to take days off school or work
No hospital stay required, only an outpatient procedure
No shaving of the hair all around the ear
Possible complications only occur rarely and are non-dangerous

This page was last updated 15 April 2013