Otoplasty Correction of prominent ears and asymmetries

Dr. Davide Costantino
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Otoplasty

Otoplasty is the plastic surgery procedure that allows for the correction of the shape and position of the ears, improving harmony and proportions of the face.

It is indicated in cases of prominent or “sticking-out” ears, asymmetries of the ear pavilion, defects in the anti-helix fold, or excessive depth of the concha.

The goal is not only aesthetic but also psychological: the procedure helps both adults and adolescents regain naturalness and self-confidence, reducing the discomfort that often accompanies this type of imperfection.

Otoplasty can be performed starting at 6-7 years of age, once the ear cartilage has completed its main developmental stage. In adulthood, it represents a definitive solution for those who desire a more discreet ear profile that is proportionate to the face, without altering the expression or leaving visible marks.

Evaluation and planning

The pre-operative visit is essential for achieving a harmonious and lasting result. The surgeon evaluates the ear morphology, analyzing factors such as skin thickness, cartilage consistency, scalp-ear angle, and symmetry between the two ears.

During the planning phase, it is determined whether to perform a bilateral or unilateral correction, the need for conchoplasty (reduction of the ear concha), and the potential reconstruction of the anti-helix fold. These evaluations help identify the most suitable technique, balancing the aesthetic appearance with the natural shape of the face.

Additionally, expectations, anesthesia type, post-operative course, and recovery time are discussed with the patient to ensure an informed and personalized journey.

Surgical technique and anesthesia

The otoplasty procedure involves a discreet incision in the post-auricular fold, the back part of the ear, making the scar virtually invisible. Through this opening, the surgeon reshapes the cartilage using permanent sutures, which define the new curvature of the anti-helix and reduce the prominence of the concha, if necessary.

In more complex cases, a small portion of cartilage may be removed to achieve a more balanced projection.

The procedure typically lasts between 60 to 90 minutes and can be performed under local anesthesia with sedation or, for younger patients or those undergoing multiple corrections, general anesthesia. The patient usually returns home the same day.

Scars, recovery, and risks

The otoplasty scar is thin and well-hidden in the post-auricular fold, making it invisible from the front. In the first few days, mild swelling or soreness may appear, which can be easily managed with analgesics and cold compresses.

The patient must wear a supportive band day and night for the first 2-3 weeks, which helps maintain the new ear position and protect the suture during sleep. Later, the band can be worn only at night for an additional two weeks.

Return to normal activities is possible after about 7-10 days, while contact sports or activities involving the head should be avoided for at least 6-8 weeks.

As with any surgical procedure, potential risks include hematomas, infections, or partial recurrence, although their incidence is very low when performed by an experienced surgeon.

Frequently asked questions from patients

Will they look “stuck”?
No. The goal of otoplasty is to return the scalp-ear angle to normal values (typically between 20° and 30°), preserving a natural look and avoiding an artificially “flat” appearance.

Will it be noticeable that I had surgery?
From the front, no, because the reshaping is done on the back of the ear. The scar, hidden in the post-auricular fold, becomes imperceptible within a few weeks.

Can they go back to the way they were?
A proper surgical technique, combined with careful post-operative care, minimizes the risk of recurrence. The ears maintain their new shape stably over time.

Otoplasty, which includes techniques like conchoplasty and anti-helix reconstruction, is now one of the safest and most requested cosmetic surgery procedures. The result is a more harmonious face and proportionate ears, with an invisible post-auricular scar and a quick recovery thanks to the post-operative band that ensures stability and protection in the early weeks.