Ear Surgery

Ear surgery encompasses procedures designed to correct the shape, position, or size of the ear. The most commonly used term is "otoplasty" for the treatment of protruding ears, but care may also address excessively large ears (macrotia), pavilion anomalies (e.g. cupped ears, asymmetric ears), or repair of damaged earlobes. These procedures are suited to children, adolescents, and adults depending on the anomaly and the request.

Common motivations include discomfort related to appearance, social difficulties at school or work, or the desire for better facial balance and a natural result. The surgical goal is to achieve a harmonious ear, proportionate to the face, while respecting individual anatomy.

This text is intended for general guidance and does not replace a personalised medical consultation.

The Different Techniques

Otoplasty for protruding ears

• Principle: reposition the auricular pavilion closer to the head by reshaping the cartilage and adjusting the attachments.
• Techniques: reshaping by sutures alone (Mustardé, Stenström technique) or a combination of sutures + cartilage resection and reshaping. The choice depends on the cartilage structure, age, and type of anomaly.
• Specifics: scars often located behind the ear (retroauricular fold) and therefore discreet. Allows correction of auricular projection and sometimes of conchal hypertrophy.

Correction of macrotia (oversized ears)

• Principle: reduction of the pavilion size by cartilage and skin resection and reshaping.
• Advantages / limitations: improves facial proportions; the technique is adapted to individual morphology and often requires a detailed assessment.

Auricular reshaping and reconstruction

• Indications: congenital deformities, trauma sequelae, partial malformations.
• Approaches: cartilage grafts, autologous reshaping, or specific reconstructive techniques depending on the defect.

Earlobe surgery

• Indications: split, elongated, or deformed earlobes after piercing.
• Technique: simple skin revision with a discreet scar.

Pre-operative Consultation

The initial consultation with the surgeon allows:

• A complete medical interview (past medical history, medications, smoking, expectations).
• A detailed clinical examination of the ears and facial symmetry.
• Presentation of adapted technical options, their advantages, and their limitations.
• Medical photography and, if necessary, simulations.
• Provision of a written quote and information leaflet.
• Explanation of pre-operative steps (possible blood tests, possible anticoagulant discontinuation, smoking advice) and precautions.

A minimum 15-day reflection period applies for all aesthetic surgery in accordance with regulations.

Procedure

• Anaesthesia: local anaesthesia with sedation for adults or general anaesthesia for young children depending on age and cooperation.
• Duration: generally 45 minutes to 2 hours depending on the extent of the correction.
• Hospitalisation: most otoplasties are performed on a day-surgery basis (same-day return home); short hospitalisation may be proposed in some cases.
• General steps: pre-operative markings, incision generally behind the ear, cartilage reshaping by sutures and/or resection, closure, application of a moulding dressing.
• Safety and traceability: signed informed consent, operative report, and documentation of follow-up elements. The surgeon and team explain the post-operative follow-up plan.

Post-operative Recovery

• Dressing: a compressive dressing maintained for 24 to 48 hours, sometimes a headband-type protection recommended at night for 2 to 4 weeks.
• Pain: moderate, relieved by simple analgesics.
• Swelling and bruising: common in the first few days, subsiding in 1 to 2 weeks.
• Scars: discreet behind the ear; maturation over several months.
• Resumption of activities: return to school or work generally within 3 to 7 days depending on the nature of the activity and extent of the procedure; resumption of contact sports after 4 to 6 weeks.
• Follow-up: check-up appointments a few days after, at 1 month, 3 months, and 1 year according to the protocol. Monitoring for haematoma, infection, or healing problems.

Results and Limitations

• Evolution: results stabilise progressively over several weeks to months, with the definitive appearance appreciated after scar maturation and complete resolution of swelling.
• Variability: the final appearance depends on cartilage quality, skin, post-operative cooperation, and individual characteristics. The goal is a natural and harmonious result, without a promise of perfection.
• Durability: as a general rule, the correction is long-lasting, but monitoring may be necessary; revisions can be discussed if an imperfection persists.

Risks and Complications

Potential complications will be explained at the consultation. The main ones are:

• Haematoma (possible drainage).
• Infection (antibiotic treatment if necessary).
• Delayed healing or unsightly scar.
• Residual asymmetry or insufficient correction potentially requiring revision.
• Temporary or, more rarely, persistent alteration of skin sensitivity.
• Partial recurrence of protrusion if correction is insufficient. These risks remain rare; they will be assessed and explained in detail during the consultation.

Alternatives and Non-surgical Options

• Neonatal ear moulding: for newborns, orthopaedic devices can sometimes correct deformities if initiated very early after birth.
• Taping (moulding dressing): can help in infants but is generally not effective beyond the first months of life.
• Injections (filler): exceptionally used to correct minor asymmetries on a temporary basis; they do not replace surgery for structural anomalies.
• Acceptance of differences and psychological support: sometimes psychological support is offered to patients whose concerns persist without a clear surgical indication.

FAQ (Frequently Asked Questions)

At what age can otoplasty be performed? For protruding ears, the procedure is often considered in children from the age of 6–7, when the cartilage is sufficiently developed and before secondary school to limit social impact. Eligibility depends, however, on psychological maturity and the individual assessment.

Will there be visible scars? Scars are generally hidden behind the ear (retroauricular fold) and become discreet over time. Their visibility depends on each person's healing quality.

Is surgery painful? Pain is moderate and well controlled by prescribed analgesics. Discomfort is mainly present during the first few days.

Can a complete asymmetry between the two ears be corrected? Yes, surgery aims to improve symmetry, but ears are rarely perfectly identical. The surgeon will explain the possibilities and limitations during the consultation.