Ear Surgery: What You Need to Know

Cosmetic ear surgery, also called otoplasty, is a type of plastic and reconstructive surgery that can improve the size, shape, or position of the outer ear by reshaping the cartilage. It can be performed at any age after the ears have stopped growing, which typically happens by age 5 or 6. 

The typical otoplasty involves correcting ears that stick out (aka ear pinning), to decrease their projection. But ear surgery may also be a good option if you want to correct a birth defect that has affected the shape of the ear cartilage or lobe; make your ears appear smaller; or fix the position or shape 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.” 

While cosmetic ear surgery doesn’t improve hearing, 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.

The surgery has a high satisfaction rate among patients, including RealSelf member moto4. “I spent most of my adult life wearing beanies or headphones to hide my ears, which protruded and resembled those of a goblin or elf,” he says. The surgery gave his ears a more natural shape, without any noticeable scars. “You’d need a microscope to know I wasn’t born like this,” he says. 

RealSelf Tip: You should see an improvement in symmetry, but don’t expect your results to look perfect. “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.

Related: From Rips to Infections, We Asked the Experts for Their Solutions to Your Outer Ear Problems

Pros

• It’s a relatively quick surgery, with permanent results.
• Ear surgery can deliver a psychological boost to patients, making them far less self-conscious about their appearance.
• There’s no age limit for otoplasty. The surgery is appropriate for both children and adults. 
• Otoplasty scars are usually hidden behind the ear, making them unlikely to be noticed in day-to-day life.
• Many ear surgeries can be performed under local anesthesia.
• The complication rate is low. 

Cons

• After surgery, a supportive headband is worn full-time for two weeks, to keep your ears in their new position. 
• Cauliflower ear (an injury to the ear common with boxers and wrestlers) is very difficult to fix, though Dr. Sedgh says that "some modest improvements can be expected, depending on the case."
• Many doctors on RealSelf say it’s not worthwhile to reduce the overall size of the ears with surgery, because it creates noticeable scarring. 
• Otoplasty surgery is expensive, and because it’s not considered a medical necessity, it’s not usually covered by insurance.

• Average Cost:
• $4,644

• Range:
• $950 - $11,001

The cost of otoplasty can vary significantly, depending on the complexity of the procedure, the type of anesthesia used, your surgeon’s level of experience, and their office location. Costs usually include follow-up appointments, but it’s a good idea to confirm this at your initial consultation. 

Most health insurance companies will cover the cost of otoplasty only if it solves a functional problem related to hearing or pain. Otherwise, it’s considered a cosmetic procedure and isn’t covered by insurance.

See our complete guide to ear surgery costs

The best candidates for ear plastic surgery are healthy patients with 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. 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 and 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 anyway and should be considered normal,” 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.

“Most people don’t have overly large ears” says Destin, Florida, plastic surgeon Dr. William Burden in a RealSelf Q&A. “The ears protrude and give the appearance of being too large.” 

However, occasionally the ear is disproportionately large to the head—and in that case, the ear can be surgically reduced in size, via a so-called wedge resection. “The trade-off is a scar on the outside surface that may be undesirably visible,” says Dr. Burden.

Ear surgery is an outpatient procedure, meaning there’s no hospital stay required and you can go home about two hours after surgery. It’s often done under general anesthesia for kids and local anesthesia in adults, but it will depend on the complexity of the procedure.  

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, while other ears might have excellent shape but are simply positioned too far out, in which case the surgery is slightly different.” 

Most patients need a combination of techniques, so your surgeon may:

• Create an incision behind or inside the ear, to minimize visible scarring
• Remove cartilage and skin, if necessary
• Use sutures to move your ear tissue into the desired position and close the incisions
• Apply bandages, to protect your ears as they heal

The entire procedure should take two to three hours, depending on the complexity of the 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, according to doctors on RealSelf, this less invasive technique is not appropriate for all patients. Discuss the technique your surgeon will use prior to having the procedure.

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

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

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

Here’s a typical timeline for ear surgery recovery. 

• After a few days, 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.

“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.

Your ears will start to look normal after a week or two as the swelling and bruising resolves. Healing is close to 80% complete by six weeks, and ears are close to fully healed by about two to three months. 

These 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, to account for this relaxation.

“If you’re thinking of getting otoplasty and have the means, do it. It changed my world. Seriously. That little improvement, knowing my ears weren’t sticking out and being a constant distraction in my mind, gave me such relief.”—KM249, RealSelf member

Ear surgery is considered safe and effective. However, like other types of major surgery, it does pose a risk of bleeding, bruising, swelling, fluid collection under the skin (seroma), numbness, visible scarring, infection, and asymmetry. Risks specific to ear surgery include undesirable cosmetic changes and the possible 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. 

Revision rates with otoplasty are generally 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.