Correction of the protruding ear

Correction of protruding ears, clinically known as otoplasty, is a surgical procedure designed to reposition ears that sit prominently away from the head. This procedure reshapes the ear cartilage to create a more natural, symmetrical appearance and a balanced facial profile. It is a highly effective solution for both children and adults who feel self-conscious about the shape or projection of their ears, providing a permanent boost in confidence and self-image.

The shape of the ear is determined by the complex folds of its underlying cartilage. Protruding ears usually occur because the "antihelical fold"—the curve inside the rim of the ear—failed to develop properly, or because the "conchal bowl"—the deep well of the ear—is overdeveloped and pushes the entire structure outward. Otoplasty addresses these structural nuances to bring the ears into a more harmonious proportion with the head.

What is Otoplasty?

Otoplasty is a reconstructive and aesthetic procedure that focuses on the framework of the ear. The surgery is highly individualized, as no two ears are identical. The surgeon uses specialized techniques to fold, shape, or remove portions of the cartilage to achieve the desired position.

Common techniques used during the procedure include:

• Cartilage Suture (Mustarde Technique): The surgeon places permanent internal sutures to create or reinforce the antihelical fold, gently "bending" the ear back into a more natural curve.
• Conchal Reduction: If the central part of the ear is too deep, a small portion of cartilage is removed to allow the ear to sit closer to the scalp.
• Cartilage Scoring: The cartilage is precisely thinned or "scored" to make it more pliable, allowing it to be reshaped into a smoother contour.

The goal is not to pin the ears back flat against the head, which can look artificial, but to create a natural-looking angle and visible "rim" when viewed from the front.

Who is otoplasty for?

Correction of protruding ears can be performed on patients of almost any age once the ears have reached their full size, which is typically around age five or six. You or your child may be a candidate for otoplasty if:

• The ears protrude significantly from the sides of the head.
• One or both ears are out of proportion with the size of the head.
• The ears have an irregular shape due to birth defects or injury.
• The projection of the ears causes psychological distress, teasing, or a lack of self-confidence.
• You wish to achieve better symmetry between the two ears.

Before the operation

The process begins with a thorough examination of the ear structure and a discussion of your aesthetic goals. Your surgeon will take precise measurements and photographs to plan the degree of correction needed for each ear. For younger patients, we ensure the child is emotionally ready for the procedure and supportive of the change.

Preoperative instructions include avoiding certain medications that can increase bleeding and, for adult patients, a requirement to stop smoking several weeks prior to surgery. Because the ears are the focus, it is helpful to have hair washed and kept away from the face on the day of the procedure.

During the operation

In adults, otoplasty is often performed under local anesthesia with sedation, while children usually receive general anesthesia for total comfort. The procedure typically takes 1 to 2 hours.

The surgeon makes a discreet incision behind the ear, in the natural fold where the ear meets the head. Through this opening, the cartilage is exposed and reshaped using the techniques discussed during your consultation. Once the ears are repositioned and symmetry is confirmed, the cartilage is secured with internal permanent sutures. The skin incision is then closed with dissolvable sutures, and a bulky "mummy-style" head bandage is applied to protect the ears and maintain their new position.

After the operation and recovery

Immediately following surgery, it is essential to keep the head bandage in place as instructed to prevent accidental pulling or bending of the ears. Most patients experience mild throbbing or aching for the first few days, which is easily managed with oral pain medication.

After the initial bulky bandage is removed (usually within a week), you will be required to wear a soft headband, similar to a sports band, at night for several weeks. This prevents the ears from being folded forward during sleep. Most children can return to school after one week, though contact sports and playground activities must be avoided for at least six weeks. The results are visible as soon as the initial dressings are removed, and the scars are conveniently hidden in the crease behind the ear.

Will the ears "pop back" out over time?

When performed correctly using permanent internal sutures, the results of an otoplasty are permanent. While a very slight degree of "rebound" is normal as the cartilage settles, the ears will not return to their original protruding position.

Where will the scars be located?

The incisions for otoplasty are placed on the back surface of the ear, tucked into the narrow groove where the ear joins the side of the head. This makes the scars virtually invisible to others, even if you have short hair or wear your hair up.

At what age is it best to have this done?

Otoplasty is unique because it is often performed on children. The ideal age is between 5 and 14 years, as the ear cartilage is more pliable and easier to reshape. Additionally, performing the surgery before a child enters a new school environment can prevent the psychological impact of teasing. However, the procedure is also very common and successful for adults.

Does otoplasty affect hearing?

No. Otoplasty only involves the external portion of the ear (the pinna or auricle). It does not involve the ear canal or the internal mechanisms of the ear responsible for hearing. Your hearing will remain exactly as it was before the procedure.