For clarification, the terms ear pinning and the technical name otoplasty are used interchangeably. I would not put too much emphasis on the term. More importantly is to think in terms of technique, there is incision less otoplasty done through skin perforations with a needle and open techniques with an incision behind the ear. Both are designed to reshape the ear. Obviously, far more can be accomplished with an open technique. Nevertheless, lets take a look at your photo. The overall size of your ear is well proportioned. There is relative under development of what we call the superior cruz of the antihelical fold, one of the most common forms of ear anomalies. This is the bend in the cartilage that sits inside the rim or helix. You can do a simple maneuver of pushing back on your ear to accentuate this fold and mimic the effect of the sutures that would be used to create this effect. If you like what you see, then you would be a good candidate for otoplasty. Much more challenging an issue to address is an under developed outer rim of the helix. This may not be possible to improve. Keep these issues in mind when considering your expectations on surgery. I'm confident you can find a surgeon in the UK, but certainly there are many of us in the US who perform this surgery.
When you say, "the fold at the top of my ear not being present", I presume you mean that the antihelix fold is not properly formed here. That is correct; the antihelix fold is only weakly bent at the top. It would be easy to bend this fold, to make it more visible, with a traditional method or with the stitch method. However, you must be aware that the ear would then move closer to the head at the top. If your ear is not protruding, you shouldn’t have the operation performed.
A well done otoplasty usually involves re-creating the missing fold in the upper pole of the ear as well as setting the lower part of the ear closer to the head (if needed). This surgery can be tailored to your ear size and specific shape. There are ideal measurements that can be used to plan your procedure and determine whether or not the lower portion of your ear needs to be set back as well. However, I agree with you based on your photos that the fold in the upper portion of your ear is only partially formed and can be enhanced with otoplasty. I hope this information is helpful.
Stephen Weber MD, FACS
Denver Facial Plastic Surgeon