Q: What are the pros and cons of ear surgery?

Pros It’s a relatively quick surgery, with permanent results. Good ear surgery results can deliver a psychological boost to patients and reduce self-consciousness about their appearance. There’s no age limit for otoplasty. The surgery is appropriate for both children and adults. Otoplasty scars are usually well hidden. Most ear surgeries can be performed in an outpatient surgery center, under local anesthesia with sedation. Complication rates are low, and patient satisfaction is high: type: embedded-entry-inline id: Ks6V6ARYAktTMUTOEu3el of reviewers on RealSelf say otoplasty was Worth It . Cons Recovery requires wearing a supportive headband full-time for up to two weeks, as the ears heal. Reducing the overall size of the ears can create noticeable scarring. Otoplasty surgery can be expensive, and if your procedure is purely cosmetic (not reconstructive or intended to correct a congenital defect), it probably won’t be covered by insurance.

Question 1

What is ear surgery?

Accepted Answer

Cosmetic ear surgery (otoplasty) is a type of plastic and reconstructive surgery that aims to improve the size, shape, or position of the outer ear, called the pinna or auricle.

In children, it can be performed after age 5 or 6, “when the ear has reached 90% of its adult size, and the cartilage has increased in stiffness,” according to the authors of a recent study.

Depending on the patient’s concerns, otoplasty can improve the appearance of ears by:

reducing the projection of protruding ears via ear pinning
making large ears look smaller
correcting an ear deformity, caused by a congenital birth defect or trauma, that has affected the shape of the cartilage or earlobe
reconstructing a folded, damaged, or missing ear (microtia)
fixing the position, shape, or size of uneven ears (when one ear looks bigger than the other)

“One of the main reasons patients seek otoplasty is to address asymmetries between the two ears,” says Dr. Jacob Sedgh, a facial plastic surgeon in Beverly Hills. “Most people have at least a minor degree of asymmetry, but in the case of prominent ears, the difference can be more obvious.”

Cauliflower ear (an injury to the ear common with boxers and wrestlers) is very difficult to fix via otoplasty, though Dr. Sedgh says that "some modest improvements can be expected, depending on the case."

Cosmetic ear surgery also can’t repair a perforated eardrum or improve hearing. But it can provide psychological benefits to people who’ve been teased about the size and shape of their ears, have experienced an ear injury, or simply want to improve their appearance.

RealSelf Tip: Some patients seek out otoplasty to correct a Stahl’s ear deformity, sometimes called elf ears or “Spock’s ear” because of the point it creates at the top. In 2022, “elf ear surgery” took on a different meaning when the musician Grimes wore prosthetic elf ears to the Met Gala and expressed her desire for surgery to make the tops of her ears pointy. The results of this body modification procedure are permanent, so most reputable plastic surgeons won’t do it: they will only reduce points, to create a normal curve.

Question 2

Can you make your ears smaller with surgery?

Accepted Answer

Ears that are disproportionately large for the head can be surgically reduced in size, via a so-called wedge resection.

However, “most people don’t have overly large ears,” notes Destin, Florida, plastic surgeon Dr. William Burden. Rather, “the ears protrude and give the appearance of being too large.”

Question 3

What are the pros and cons of ear surgery?

Accepted Answer

Pros

It’s a relatively quick surgery, with permanent results.
Good ear surgery results can deliver a psychological boost to patients and reduce self-consciousness about their appearance.
There’s no age limit for otoplasty. The surgery is appropriate for both children and adults.
Otoplasty scars are usually well hidden.
Most ear surgeries can be performed in an outpatient surgery center, under local anesthesia with sedation.
Complication rates are low, and patient satisfaction is high: type: embedded-entry-inline id: Ks6V6ARYAktTMUTOEu3el of reviewers on RealSelf say otoplasty was Worth It.

Cons

Recovery requires wearing a supportive headband full-time for up to two weeks, as the ears heal.
Reducing the overall size of the ears can create noticeable scarring.
Otoplasty surgery can be expensive, and if your procedure is purely cosmetic (not reconstructive or intended to correct a congenital defect), it probably won’t be covered by insurance.

Question 4

How much does otoplasty cost?

Accepted Answer

Ear surgery costs can vary significantly, depending on:

the complexity and length of the procedure
the type of anesthesia used
your surgeon’s level of experience and reputation
their practice location

Purely cosmetic procedures are not covered by insurance, though most health insurance companies will cover otoplasty costs if the procedure is intended to correct a congenital problem, such as a misshapen ear or asymmetry, especially in children. Ear reconstruction may also be covered.

See our complete guide to ear surgery costs

Question 5

Otoplasty before and after pictures

Accepted Answer

The ear surgery photos in our gallery have been shared by the surgeon who performed the procedure, with the patient's consent.

Question 6

Who makes a good candidate for ear surgery?

Accepted Answer

The best candidates for ear plastic surgery are healthy patients who are over age 5 and have reasonable expectations, says Dr. Matthew Richardson, a facial plastic surgeon in Frisco, Texas.

“Some patients have unrealistic expectations about perfect symmetry or making the ears too flat to the head,” Dr. Richardson explains. “Patients need to understand that a normal ear sticks out from the head enough to allow for normal washing within the crease behind the ears and enough for patients to be able to wear glasses, certain types of earbuds, and hearing aids.”

Each and every ear is slightly different, even on the same person. “The nice part about ears being slightly asymmetric is that people really only fully see one ear on a person at a time, so small asymmetries are not noticeable,” says Dr. Richardson.

Poor candidates for otoplasty include patients with bleeding disorders, wound-healing disorders, or other serious medical conditions that might make anesthesia or elective surgery risky.

Question 7

How does ear surgery work?

Accepted Answer

Ear surgery is an outpatient procedure that’s typically performed under general anesthesia for kids and local anesthesia in adults. Depending on the complexity of the procedure, you may also be given oral sedation.

Surgical techniques vary based on your goals, but generally, otoplasty involves two primary aspects: reshaping the ear and moving the entire ear closer to the head.

“There are surgical nuances related to how this is performed, and each ear is different,” says Dr. Richardson. “Some ears might need only a few sutures, to change the shape of the upper part of the ear. Other ears might have excellent shape but are simply positioned too far out.”

Most patients need a combination of techniques, such as:

Creating an incision behind or inside the ear, to minimize visible scarring
Removing cartilage and skin, if necessary
Folding or otherwise manipulating the cartilage of the ear, using sutures to secure the tissue into the desired position
Closing the incisions and applying bandages, to protect your ears as they heal

The entire procedure should take two to three hours, depending on the complexity of your case.

Some surgeons employ another type of ear pinning surgery known as an incisionless otoplasty, during which stitches are placed through the skin to reshape prominent ears. However, this minimally invasive technique is not appropriate for all patients.

After surgery, your head will be temporarily wrapped in a bandage or headband, to protect your ears and keep them in place in order to ensure the integrity of the results.

Question 8

How long does otoplasty recovery take?

Accepted Answer

Adults are usually able to return to normal activities within a few days. For children, a week off school is usually recommended.

“Otoplasty has a relatively less demanding and painful recovery phase, compared to most other cosmetic surgeries,” says Dr. Sedgh. “The fact that this surgery is often performed in the pediatric population implies a favorable postoperative pain and discomfort profile, too.”

Here’s a typical otoplasty recovery timeline:

A few days post-procedure, the bandage will be replaced with a soft headband. “The biggest risk is damaging the surgical correction,” says Dr. Richardson. He recommends that his patients wear a protective headband at all times for the first two weeks and then at night after that, but Dr. Sedgh says that most surgeons require it for only one week, and then at night. Your surgeon may have you sleep on elevated pillows and not on your side, to avoid putting any pressure on your ears.
Sutures will be removed after a week.
Your ears will be tender, swollen, and red for several weeks after the procedure, with bruising around the ears. You can expect mild discomfort (itching, swelling, and throbbing) that will be controlled with oral pain medications. Avoiding strenuous activity for two weeks after surgery will help keep the swelling down.
It’s common to have some numbness of the ears that usually resolves within a month, but it may persist for up to six months.
After four to six weeks, you’ll be able to resume all normal activities, including sports.
Most patients are fully healed within two to three months.

“The recovery period is critical to the overall success of ear surgery, so be sure to follow all of your doctor’s post-operative instructions,” says Dr. Sedgh.

Question 9

Are results permanent?

Accepted Answer

Otoplasty results are permanent and should last a lifetime. “Some very minor degree of relaxation is possible over the first few months after surgery, but this isn’t something that I commonly see in my patients after around three months post-operatively,” says Dr. Richardson. In some cases, the surgeon may very slightly overcorrect the ears, in anticipation of this relaxation.

Most patients see improved symmetry post-surgery, but don’t expect your results to look perfectly even. “Even though you can expect significant aesthetic improvement and resemblance between two ears with otoplasty, it’s almost impossible to make both sides look exactly the same,” says Dr. Sedgh.

Question 10

Is ear surgery safe? What are the side effects?

Accepted Answer

Ear surgery is considered safe and effective. Studies have also shown otoplasty to improve patients’ quality of life, confidence, self-esteem, and body image.

However, like other surgical procedures, it comes with a few risks. The most worrisome potential complication is post-op hematomas (essentially, severe bruising), which are usually seen one to three days after surgery.

Other risks include:

Bleeding
Bruising
Swelling
Fluid collection under the skin (seroma)
Numbness
Poor scarring
Infection
Asymmetry
Overcorrection
Unsatisfactory outcomes (the most common complication of otoplasty)

Risks specific to ear surgery include undesirable cosmetic changes and a potential need for revision surgery. “One of the main challenges during otoplasty is to factor in differences of contours and angles of the ear and obtain results with minimal asymmetries,” says Dr. Sedgh.

Otoplasty revision rates are low, but there are dozens of patients on RealSelf asking about revision otoplasty because their ears were overcorrected and pinned too flat against their heads, in a way that doesn’t look natural.

Question 11

What are the alternatives to ear surgery?

Accepted Answer

If you want a less invasive (and less costly) surgery to pin back prominent ears, consider Earfold. This small implant is inserted under the skin in the upper ear cartilage, to permanently tack back ears that have a slight prominence. The procedure requires only a local anesthetic.

There are no completely nonsurgical otoplasty procedures, but some people use transparent adhesive between their ears and head in order to pin their ears at home. This temporary solution can irritate the skin, especially if you use it long-term.

EAR SURGERY

Jacob Sedgh, MD

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Jacob Sedgh, MD

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Jacob Sedgh, MD

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