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.


