Otoplasty: Ear Reshaping and Correction Surgery London

When ears sit noticeably away from the head, appear uneven, or feel out of proportion with the rest of the face, they can become a source of self-consciousness. Otoplasty is a surgical procedure used to reshape or reposition the ears, most commonly to reduce prominence or improve asymmetry. Also known as ear pinning or ear reshaping surgery, otoplasty is available through botonics at our Harley Street clinic in London.

Prominent ears are not necessarily larger than average. In many cases, they sit further away from the head because the natural folds in the ear cartilage have not developed in the usual way, or because the central part of the ear projects more than usual. Otoplasty reshapes and repositions this cartilage to bring the ears into better balance with the head and face.

What Can Otoplasty Correct?

Otoplasty may be used to address several concerns involving the shape, position or proportion of the ears, including:

• Protruding ears: Where one or both ears sit further away from the head because of the way the cartilage has developed
• Asymmetric ears: Where one ear differs noticeably from the other in position, shape or prominence
• Overly large ears: Where the size or proportions of the ear appear out of balance with the face
• Stretched or damaged earlobes: Earlobe repair is a separate procedure, although it may sometimes be carried out alongside ear reshaping where appropriate

Otoplasty may be considered for both adults and children, though in younger patients the cartilage is generally more pliable. Where non-surgical moulding is no longer an option, surgery may be considered once the ears have developed sufficiently. Timing depends on more than physical development: the surgeon will also consider whether the child understands and wants the change themselves.

Otoplasty can help with prominent or asymmetric ears caused by cartilage shape, but it is not suitable for every ear condition. Microtia and anotia, where the external ear is underdeveloped or absent, require a different and considerably more complex reconstructive approach.

The final result also depends on the existing shape and flexibility of the cartilage. Human ears are rarely perfectly symmetrical to begin with, so the aim of otoplasty is improved balance rather than identical, mirror-image ears. A small degree of asymmetry may remain after surgery.

The Otoplasty Procedure

Otoplasty works by reshaping and repositioning the cartilage that determines how the ear sits against the head. In prominent ears, this may involve recreating or strengthening the natural folds in the cartilage, reducing excess projection, or a combination of the two.

A small incision is usually made behind the ear, so the resulting scar sits in a naturally concealed position. Through this incision, the surgeon can reshape the cartilage and use internal sutures to bring the ear closer to the head. Excess skin may also be removed. Where excess cartilage contributes to the prominence, a small amount may be removed or repositioned.

For many adults and suitable older patients, otoplasty can be carried out under local anaesthetic, with sedation available where appropriate. Younger children will usually require general anaesthetic, and the most appropriate option will be discussed with you during consultation.

The procedure typically takes between one and two hours and is usually performed as a day case, so an overnight stay is not normally required.

Am I a Suitable Candidate for Otoplasty?

Otoplasty may be suitable for adults and children who are concerned about prominent, asymmetric or disproportionate ears and who have realistic expectations about what surgery can achieve.

Suitability is assessed individually. Your surgeon will consider your general health, the shape and quality of the ear cartilage, your goals and any factors that could affect surgery or healing.

Factors that may need to be addressed or discussed before surgery include:

• Active skin infection or open wounds in the treatment area: These will need to resolve before an operation can take place.
• Expectations that cannot realistically be achieved: Your surgeon will explain what surgery may and may not change and will not recommend treatment where the expected result is unrealistic.
• Young age: Otoplasty is generally considered once the ears have developed sufficiently, commonly from around five years of age. In children, emotional readiness and the child’s own wishes are also important considerations.

If you are not sure whether otoplasty is appropriate for you or your child, a consultation with one of our specialist surgeons at our Harley Street clinic is the place to start. The purpose of that consultation is to understand the concern, assess suitability and give you clear advice. There is no pressure to proceed.

Your Journey From Start To Finish

1. Step One

   Consultation and Planning

   Your journey begins with a consultation with your botonics surgeon. They will examine your ears, discuss your concerns and explain which approach may be appropriate, including expected recovery and what surgery can realistically achieve.

2. Step Two

   Preparation

   On the day of surgery, the ears are marked and the appropriate anaesthetic is administered. Many adult procedures can be performed under local anaesthetic, with sedation available where suitable. General anaesthetic may be recommended for younger patients.

3. Step Three

   The Procedure

   A small incision is usually made behind the ear. The surgeon reshapes and repositions the cartilage using carefully placed sutures, with excess cartilage or skin removed where necessary. The procedure typically takes one to two hours.

4. Step Four

   Recovery and Aftercare

   A protective dressing is placed around the head to support the ears as they heal. Most patients go home the same day, and follow-up appointments are arranged to monitor recovery.

Otoplasty Recovery: What to Expect

Recovery after otoplasty happens in stages, and the exact timing varies from person to person. Swelling, tenderness and changes in sensation are expected during the early healing period.

• Days 1 to 3: Swelling, bruising and discomfort are common. A protective head dressing will usually remain in place and should be kept on for as long as your surgeon advises.
• Days 5 to 10: The initial bulky dressing is commonly removed during this period. Depending on your surgeon’s instructions, you may then be asked to wear a lighter headband, particularly at night, to protect the ears while the cartilage continues to settle.
• Weeks 1 to 2: Many people are able to return to desk-based work or school within one to two weeks. The ears can still feel tender, numb or unusually sensitive and should be protected from knocks, bending or pressure.
• Weeks 2 to 6: Swelling continues to settle and the new position of the ears becomes easier to appreciate. Normal day-to-day activities can gradually be resumed, although swimming and other activities that put pressure on the ears may need to wait.
• Around 8 weeks: Contact sports and activities where the ears could be knocked are usually avoided for longer and should only be resumed once your surgeon confirms that healing is sufficiently advanced.

The ears may continue to feel firm, stiff or slightly numb for several months. Results are generally long-lasting, although a small number of patients may experience some loss of correction over time and occasionally require revision surgery.

Before & After Case Studies:

View more Otoplasty before and after case studies.

Risks and Complications of Otoplasty

Every surgical procedure carries risks. Your surgeon will explain these carefully during your consultation so that you can make an informed decision about whether otoplasty is right for you.

• Asymmetry: Perfect symmetry is not a realistic aim, and a small difference between the ears may remain after surgery. More noticeable asymmetry can occasionally occur.
• Bruising and swelling: These are common after surgery and usually improve progressively during the first few weeks.
• Haematoma: A collection of blood can occasionally develop beneath the skin after surgery and may require prompt assessment or treatment.
• Infection: Infection is uncommon but can occur. If an infection affects the ear cartilage, it needs prompt medical attention because it can affect the shape of the ear.
• Scarring: The incision is normally positioned behind the ear so that the scar is relatively discreet. All surgery leaves a scar, however, and some people are more prone to raised or thickened scarring.
• Altered sensation: Numbness, tingling or changes in sensation around the ears can occur after surgery and are often temporary.
• Suture problems: Internal sutures can occasionally become noticeable, irritate the skin or work their way towards the surface and may need treatment or removal.
• Over-correction or uneven shape: Changing the cartilage can occasionally create excessive setback or an uneven result that may require further assessment.
• Partial return of prominence: The ear can gradually move back towards its previous position in some cases, causing some loss of correction.
• Revision surgery: Further surgery is occasionally required because of recurrence, asymmetry, healing problems or another aspect of the final result.