PROMINENT EARS SURGERY
DEFINITION, AIMS AND PRINCIPLES
The correction of prominent ears needs a surgical procedure
called “otoplasty”, which the goal is to reshape the auricles.
The surgery is usually performed on the two auricles but
could be done unilaterally.
An otoplasty corrects the auricle’s cartilaginous abnormalities
which are the cause of the prominent aspect. Schematically,
we can distinguish three types of abnormalities which are
often, more or less, associated :
- Too open angle between the auricle and the skull,
carrying out the so called “prominence” (valgus
- Too large size of the conchal cartilage (see diagram)
projecting forward the ear which improves the
prominent aspect (concha hypertrophy).
- Failure into the normal cartilage reliefs folding
which gives a too
smooth, like “unpleated”, aspect
to the ear (lack of
Surgery, definitively, corrects
these abnormalities, by
reshaping the ear cartilage, in
order to obtain wellpositionned,
also natural in size and aspect.
So, prominent ears surgery
also ends the mockeries and
other unpleasant remarcks which may have induced
psychological difficulties or school problems.
An otoplasty can be performed in an adult, in an teenager or,
most of the time in a 6-7 years old child, as soon as the child
starts suffering of his/her ear aspect.
BEFORE THE OPERATION
A meticulous clinical examination of the ears will be realized
by the surgeon himself to determine the needed
HOSPITAL STAY AND TYPE OF ANESTHESIA
Type of anesthesia
- Local anaesthesia completed by tranquillizing drugs, Injected in veins (“vigil” anaesthetic)
- Classical general anaesthesia, which puts you asleep
The surgery can be done in the “day care” department; it
means, you can leave hospital the same day of the surgery,
just after a few hours of resting and medical supervision.
- Skin incisions:
Usually, there are inside the natural
- Dissection :
The skin will be then undermine to
allow the cartilage to be reached.
- Cartilage reshaping :
The principle of this surgery is to create or improve
the natural reliefs of the auricles by thinning and/or
bending the cartilage framework, which may
necessitate deep fine stiches. Sometimes, cartilage
cuting or partial removing is indicated. Finally, the
auricles are put back in a good position, in relation to
the skull, and anchored by deep stiches.
- Sutures :
Usually, the skin is closed using absorbable stiches;
if not, the stiches must be taken away within 10 days
- Dressing :
It is done with elastic bandages around the head to
keep the ears in a good position.
Depending on the surgeon and on the gravity of abnormalities
to be corrected, the surgery may take half an hour to one hour
and half, for both ears correction.
THE SURGICAL FOLLOW-UP
Pains are usually moderate and if necessary, they can be
treated using pain killers or anti-inflammatory drugs.
In the contrary, in case of persistant pain, you must consult
the surgeon or someone of his team.
The first big dressing is taking away within 2 to 5 days
following surgery. It will be replaced by a lighter one for
another few days.
During the early follow-up period, ecchymosis (bruises) and
edema (swelling hidding the ear reliefs) can appear. This
matter of fact should not worry you; it will be transitory and
not affecting the final result.
A maintaining and protecting head-band wil be use day and
nights for 15 days and then for another few weeks, during
night, only. During this period of time, we must avoid any
sport activity or working out, especially with risk of contacts.
You must also avoid high cold temperature for at least 2
months after surgery, due to the frost-bite risk because of the
transitory sensitiveness abatement.
It will be appreciated within 1 to 2 months after surgery. It is
the time needed for the edema to disappear, allowing the ear
reliefs to be clearly seen. After this period of time, only the
scar will be red and harden for another few month before
In most of the cases, the result is definitivelly obtained. But
sometimes, a slight (as a rule) recurrence of the prominent
aspect of the ear may occur and indicate a slight secondary
They can appear after a while, due to unexpected tissue
retraction or unusual scarring process.
So, we may, sometimes notice light asymetry between the
two ears, small irregularities of the ear reliefs, too acute
cartilage plicature, narrowing of the ear meatus or deep
All these so called “small failures” are discret and not seen by
others. Anyway, we can always correct them and refine the
result under local anaesthesia.
- The post-operative bleeding : if it is more then just a
blood fleck on the dressing (what should not make
you anxious) a secondary surgery may be necessary
to stop the bleeding. But the blood, sometimes, can
stay inside, giving an haematoma which could
indicate its evacuation to protect the quality of the
- An infection is fortunately rare thanks to the
rigorous pre-operative asepsis rules. But if an
infection occurs, it needs a quick treatment to avoid
to reach the cartilage which can have severe
- Skin necrosis can exceptionally be seen. It is usually
limited and localized at the anterior side of ear relief
where the skin is very thin and the blood supply
disturbed. The scarring just needs local dressings
and a small discret scar may remain.
- Abnormal scars : in spite of all the care of the
suturing, a ear scar, of any kind, can always become
hypertophic or even more “a cheloid scar” the
treatment of which remains difficult.