Otoplasty (Prominent Ear Surgery)

Definition

Otoplasty, commonly referred to as prominent ear correction surgery, is a procedure designed to reposition the ears closer to the head and improve their shape for a more natural and harmonious appearance.
The most common indication is congenital prominent ear deformity, in which the auricles protrude more than normal. This condition may cause aesthetic concerns and self-confidence issues, particularly in childhood, but it can persist into adulthood.

Through reshaping of the auricular cartilage, otoplasty restores a natural ear-to-head angle, corrects asymmetries, and contributes to overall facial balance and aesthetics.

Indications

Otoplasty is performed in patients who present with:

Protruding ears: Auricles positioned at a wider angle to the head, causing a noticeable outward projection.
Ear asymmetry: One ear appearing more prominent than the other.
Childhood prominent ear deformity: Surgery can be performed as early as 5–6 years of age, when auricular growth is nearly complete, to prevent psychosocial distress.
Adults with persistent deformity: Otoplasty is also suitable for adults who remain uncomfortable with the appearance of their ears.

Ideal candidates are individuals in good health, non-smokers, and those with realistic expectations regarding surgical outcomes.

Surgical Technique

Prominent ear surgery is typically performed under local anesthesia in adults and takes approximately 1–2 hours. In children, it is often performed under general anesthesia for comfort and safety.

Steps of the Procedure:

Incision: A small incision is made behind the ear, hidden in the natural crease.
Cartilage reshaping: The auricular cartilage is sculpted and, if necessary, sutured into its new position to create a more natural fold and angle.
Repositioning: The ears are set closer to the head, correcting excessive projection.
Closure: Incisions are closed with fine sutures; scars remain well concealed behind the ear.

This minimally invasive approach typically yields permanent, natural-looking results.

Preoperative Considerations

Smoking cessation: Smoking impairs wound healing and should be discontinued at least 2 weeks prior to surgery.
Discontinuation of anticoagulants: Blood-thinning agents such as aspirin must be stopped under medical guidance to minimize bleeding risk.
General health assessment: A complete evaluation ensures the patient’s suitability for anesthesia and surgery.

Postoperative Course

Recovery after otoplasty is generally rapid, and patients often return to daily activities within a few days.

Key recovery milestones include:

Bandages: A protective head bandage is applied postoperatively to maintain the ears in their new position. Bandages are typically worn for 1 week, followed by a lighter headband at night for several additional weeks.
Swelling and bruising: Mild edema and ecchymosis may occur and usually resolve within 7–10 days.
Sutures: Most sutures are absorbable; if not, they are removed within 7–10 days.
Precautions: Patients should avoid sleeping face-down, applying pressure to the ears, or engaging in contact sports for the first month.
Full recovery: The ears typically stabilize into their final shape within 4–6 weeks.

Risks and Complications

As with any surgical intervention, otoplasty carries potential risks. These are uncommon when the procedure is performed by an experienced surgeon but may include:

Infection
Bleeding or hematoma
Delayed wound healing
Cartilage irregularities or distortion
Residual asymmetry
Hypertrophic scarring (rare)

Proper surgical technique and adherence to postoperative instructions minimize these risks and contribute to predictable outcomes.

Outcomes

Otoplasty provides long-term correction of prominent or asymmetric ears, leading to a more natural, balanced facial appearance. The procedure not only addresses aesthetic concerns but also enhances psychological well-being and self-confidence, particularly in children and adolescents.

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