Otoplasty: Correction of Prominent Ears

Prominent ears are a common congenital anatomical feature that does not affect health or hearing. However, a more pronounced shape or projection of the ears may affect self-confidence, particularly in children and adolescents.

Otoplasty is a surgical procedure used to change the shape, position or size of the external ears. Most commonly, the ears are positioned closer to the head and the natural folds of the ear cartilage are reshaped.

The procedure can be performed in both children and adults, and the correction is always tailored to the individual anatomy.

When is otoplasty suitable?

Patients most commonly consider ear correction because of:

• noticeably prominent ears,
• an underdeveloped inner fold of the ear,
• an excessively prominent conchal bowl,
• differences in the position or shape of the left and right ear,
• overly large ears,
• congenital or acquired cartilage irregularities,
• dissatisfaction that affects confidence or everyday wellbeing.

Prominent ears are often caused by a combination of an underdeveloped antihelical fold and a more pronounced concha. For this reason, there is no single technique that is suitable for every patient. The surgeon selects the method according to the shape and firmness of the cartilage and the desired result.

Otoplasty in children

The procedure can be performed once the ears are sufficiently developed, often from approximately five or six years of age. More important than the exact age are the child's maturity and willingness to cooperate during the consultation, procedure and recovery.

The decision should not be based solely on the parents' wishes. The child should also want the change and understand why a bandage or protective headband will need to be worn after surgery.

The procedure is often planned before starting school or during the early school years, but not every child with prominent ears requires surgery. Otoplasty is an elective aesthetic procedure.

There is no upper age limit for adults, provided their general health allows the operation to be performed safely.

What can be changed?

Otoplasty can be used to:

• reduce the distance between the ear and the head,
• create or define an underdeveloped cartilage fold,
• reduce the prominence of selected parts of the ear,
• improve differences between the left and right ear,
• reduce the size of an overly large ear,
• correct certain cartilage deformities.

The procedure does not affect hearing, as it treats the external ear and does not involve the structures of the middle or inner ear.

Otoplasty also cannot always make both ears completely identical. A degree of asymmetry is normal and is present in almost every face.

How is the operation performed?

Before surgery, the surgeon examines the shape and position of both ears, assesses cartilage firmness and discusses expectations with the patient or parents.

In children, otoplasty is usually performed under general anaesthesia. In adults, it can often be performed under local anaesthesia, sometimes combined with sedation.

The procedure usually takes approximately one to two hours.

The incision is most often placed in the natural fold behind the ear. Through this approach, the surgeon may:

• reshape the cartilage,
• create or define natural ear folds,
• reduce the prominence of selected structures,
• position the ear closer to the head,
• secure the new shape with sutures.

The surgical technique may involve a combination of sutures, cartilage reshaping and, in some cases, removal of a small amount of cartilage.

A protective bandage is applied after surgery. Most patients can leave the clinic on the same day.

Where is the scar located?

In a standard prominent ear correction, the scar is usually located behind the ear in the natural skin fold.

At first, it may appear pink, firm or slightly more noticeable. It generally fades and softens gradually over time. Because of its position, it is usually well hidden once healing is complete.

Recovery after otoplasty

Swelling, tenderness, bruising and a feeling of tightness are common after the procedure. Discomfort can usually be managed with prescribed pain medication.

Recovery depends on the surgical technique and the surgeon's instructions, but a typical timeline may include:

• First week: the protective bandage remains in place continuously;
• After bandage removal: the ears may still be swollen, red and sensitive;
• Following weeks: a soft elastic headband is often worn at night or while sleeping;
• After one to two weeks: most adults can return to work and children can usually return to school;
• After several weeks: gradual return to sport and activities with a risk of impact or pulling on the ears;
• Within a few months: swelling fully settles and the result becomes more stable.

The exact duration of bandage and headband use is determined by the surgeon. The dressing should not be removed or adjusted without instructions, as it protects the new ear position during early healing.

What should be considered after surgery?

During recovery, we generally recommend:

• sleeping on your back with the head slightly elevated,
• avoiding pressure on the operated ears,
• taking care when pulling clothing over the head,
• wearing the protective headband as instructed,
• avoiding contact sports and rough play,
• protecting the ears from impact, pulling and strong sunlight,
• attending scheduled follow-up appointments.

For children, it is helpful to inform teachers, carers and sports coaches about the temporary restrictions.

What result can you expect?

The change in ear position is visible after the first bandage is removed, although the ears will still be swollen.

Once the swelling settles, the ears are usually:

• positioned closer to the head,
• more naturally shaped,
• better balanced with the face,
• more similar to one another.

The result is generally long-lasting. The aim is not to press the ears completely flat against the head or create perfect geometric symmetry. Excessive correction may look just as unnatural as very prominent ears.

When may surgery not be suitable?

The operation may be postponed in cases of:

• an active ear or skin infection,
• acute illness,
• uncontrolled medical conditions that may affect healing,
• significant blood-clotting disorders,
• inadequate preoperative preparation,
• unrealistic expectations,
• a child who is not ready or willing to undergo the procedure.

Suitability is always assessed individually during the surgical consultation.

Consultation for a child or an adult

During a consultation at Klinika Višnjar, the surgeon examines the anatomy of the ears, explains the available methods of correction and discusses the expected result.

For children, the consultation includes both the parents and the child. It is important that the child understands the procedure, wants the change and is prepared to cooperate during recovery.

Our aim is a natural correction in which the ears are not positioned excessively close to the head, but appear more balanced with the face and with one another.

Book a consultation at Klinika Višnjar in Ljubljana so that we can assess whether otoplasty is a suitable option for you or your child.