Otoplasty is the operation that corrects the shape of the outer ear and its position relative to the head; the most common reason is prominent ears. Ear, nose and throat specialist Op. Dr. Süleyman Kumbasar, whose practice is in Bahçelievler, Istanbul, determines at the consultation whether the cause is an underdeveloped fold or a deep concha. The incision is made behind the ear and the hearing structures are not touched. In children it is usually planned from the age of 5–6; in adults there is no upper age limit.
What is otoplasty?
Otoplasty is an operation that corrects the shape of the outer ear and its position relative to the head. The most common otoplasty corrects prominent ears, often called sticking-out ears, which stand clearly away from the head. The operation is carried out only on the outer ear; hearing structures such as the middle or inner ear are not touched. Problems such as hearing loss, pain or discharge are assessed separately, under ear conditions.
Why do prominent ears occur?
Prominent ears are usually present from birth, and they often run in families. There are two main causes, which can occur together in the same ear:
- Underdevelopment of the Y-shaped fold of the outer ear (antihelix): the upper part of the ear opens forwards.
- A deep concha (the hollow area around the ear canal): the whole ear is pushed forwards.
Normally the angle between the outer ear and the head is about 20–30 degrees. A marked increase in this angle, with the rim of the ear standing away from the head, gives the appearance of prominent ears.
At what age is it done?
The ear reaches most of its adult size by around 5–6 years of age. That is why, in children, the operation is usually planned from this age, often before starting school. In adults there is no upper age limit; if general health allows, it can be done at any age. In newborns the cartilage is very soft, and moulding methods (ear moulding) started in the first weeks can correct the shape without surgery in some babies. Other ENT topics in children are on the paediatric ENT page.
How is the operation done?
The incision is made in the natural crease at the back of the ear; the scar stays in this area and is not usually visible from the front. The missing fold is recreated with permanent stitches placed in the cartilage. If the concha is deep, the ear is set back by fixing the conchal cartilage towards the head or by removing part of it. The technique is chosen according to the stiffness of the cartilage and the cause of the prominence. One or both ears can be operated on; the aim is a balanced, natural look between the two.
Earlobe corrections
Reducing a large or drooping earlobe and repairing an earlobe torn by an earring are also part of otoplasty. These procedures are usually done under local anaesthetic and take little time.
After the operation
After surgery, a dressing is placed around the ears and removed at the first check-up. An elastic headband that protects the ears is then worn: continuously in the first weeks and then, for a few weeks, only at night. The headband stops the ear folding on the pillow during sleep and helps the cartilage heal in its new position. Sensation in the ear may be reduced for a few weeks; during this time, hot hairdryers and hats or helmets that press on the ear are avoided.
What are the risks?
Possible risks include bleeding and a collection of blood behind the ear (haematoma), infection, asymmetry between the ears, the ear partly returning to its previous position, stitches that can be felt under the skin and thickening of the scar at the back. In the first days after surgery, increasing pain on one side can be a sign of a haematoma, so the doctor should be contacted without delay. The risks are explained at the consultation before surgery and written informed consent is obtained.
The surgical process
General anaesthesia in children; in adults, usually local anaesthesia with sedation if needed.
For both ears, usually 1 to 2 hours.
Most patients go home on the same day.
The first dressing is usually removed between days 1 and 3; after that an elastic headband is worn.
Recovery timeline
Swelling, tenderness and mild pain in the ears; pain is usually controlled with oral painkillers.
The dressing is removed and the ears are checked; the headband is worn continuously. Returning to school or office work is usually possible during this period.
The stitches are removed or dissolve on their own; the headband is still worn.
The headband is worn only at night. Contact sports and activities with a risk of a blow to the ear wait for the doctor’s approval.
Most of the swelling has gone down; the final position of the ears is assessed.
Frequently asked questions
At what age are prominent ears corrected?
Because the ear reaches most of its adult size by around 5–6 years of age, in children the operation is usually planned from that age. In adults there is no upper age limit.
Does otoplasty affect hearing?
The operation is carried out only on the cartilage of the outer ear; the ear canal, eardrum, middle ear and inner ear are not touched. It is therefore not expected to affect hearing. If there is a separate hearing problem, it is assessed separately.
Can the ears stick out again after the operation?
Because cartilage is elastic, in some patients the ears can partly return to their previous position. Permanent stitches are used to reduce this risk, and wearing the headband during recovery is important. If the ears stick out markedly again, a further correction is considered.
Can just one ear be operated on?
Yes. If only one ear clearly sticks out, one side can be operated on. Because the aim is symmetry, both ears are assessed together when planning.
How long is the headband worn after the operation?
Usually continuously for the first 1–3 weeks and then, for a few weeks, only at night. The exact time is decided at check-ups, according to how the ear is healing.
Can otoplasty be done under local anaesthetic in adults?
Yes. In adults, the operation is usually done under local anaesthetic, with sedation if needed. In children, general anaesthesia is preferred.
Related treatments
Sources
- Nazarian R, Eshraghi AA. Otoplasty for the protruded ear. Seminars in Plastic Surgery, 2011.
- Mogl AG et al. Conchal Excision Techniques in Otoplasty: A Literature Review. Plastic and Reconstructive Surgery Global Open, 2022.
The information on this page is for general guidance only; diagnosis and treatment decisions are made by the doctor after a consultation. Results of surgical and interventional procedures vary from person to person.