Pinning of the ear(s) may be performed in an office operating room, an AAAASF approved surgical center, or a hospital operating room. Depending on the individual patient’s pain tolerance, comfort with awake procedures, and acceptance of the risks of general anesthesia, otoplasty may be performed under straight local anesthesia, local anesthesia with sedation, or local anesthesia combined with general anesthesia. The type of anesthesia will, to some degree, limit the setting in which otoplasty may be performed.