What is an otoplasty?

An otoplasty is a surgical procedure designed to reshape, reposition or reduce the prominence of the ears.

It is most commonly performed for prominent ears, which may be caused by underdevelopment of the natural ear fold, excess ear cartilage, or a combination of both.

Some patients seek otoplasty because their ears have always sat further forward than they would like. Others are concerned by asymmetry, congenital ear shape differences, previous trauma or dissatisfaction following earlier ear surgery.

Prominent ears can affect confidence at any age. Children may experience teasing or self-consciousness, while adults often describe years of avoiding certain hairstyles, covering their ears or feeling embarrassed about their appearance.

Otoplasty surgery aims to bring the ears into better balance with the face while maintaining a natural ear shape. The goal is not to make the ears look “pinned back” or artificial, but to create a more balanced contour that suits the individual.

Who is suitable for an otoplasty?

Otoplasty may be appropriate for children or adults with prominent ears, ear asymmetry, congenital ear shape concerns or dissatisfaction following previous ear surgery.

In children, otoplasty is usually considered once the ears have reached near-adult size, often around five to six years of age. Adult otoplasty is also common and can be very effective.

Good candidates are generally seeking a natural improvement in ear position or shape and understand that perfect symmetry is not possible.

Factors that can affect suitability include smoking, poor wound healing history, previous ear surgery, cartilage quality, unrealistic expectations and active skin or ear infection.

These factors will be carefully assessed during consultation with your surgeon, Dr Alex Cameron. 

Revision otoplasty following previous ear surgery can be more complex due to scar tissue and changes in cartilage structure, and this will be discussed during consultation where relevant.

What preparation is required for an otoplasty?

Preparation for otoplasty begins with a detailed assessment of your ear shape, ear projection, cartilage structure and symmetry.

Dr Alex Cameron will discuss what concerns you most, what level of correction is realistic, and how to achieve a natural result without making the ears appear overcorrected.

If you have had previous ear surgery, trauma or infection, this will also be reviewed during planning.

Preparation may also include smoking cessation, management of any skin or ear infection, and planning for post-operative protection of the ears.

The goal is to create a natural, balanced ear shape while preserving normal ear anatomy and function.

How is it performed?

An otoplasty is usually performed as day surgery and takes approximately 1.5–3 hours, depending on complexity.

Most children have the procedure under general anaesthetic. Many adults can have otoplasty under local anaesthetic with sedation or general anaesthetic, depending on the procedure and personal preference.

The surgical approach depends on the specific anatomy being treated. For many patients, surgery involves creating or strengthening the natural fold of the ear, reducing or repositioning excess cartilage, and setting the ears closer to the head. Incisions are usually placed behind the ears so that scars are well concealed.

Techniques may include permanent internal sutures to reshape the cartilage, cartilage scoring or weakening techniques, or cartilage removal in selected cases.

The operation is carefully tailored to create natural contours, appropriate symmetry and a balanced degree of ear projection. The aim is to avoid an overly flattened or surgically obvious appearance.

A protective head dressing is applied at the end of surgery. This is usually worn continuously for the first week before transitioning to a lighter supportive headband, particularly at night. Drains are not required.

Dr Cameron performs otoplasty procedures at Burnside Hospital, St Andrew’s Hospital or Glenelg Community Hospital.

What outcome can I expect to achieve?

An otoplasty can significantly improve ear prominence, symmetry, contour and overall facial balance.

The goal is for the ears to sit in a more natural position without looking overly pinned or surgically altered.

Many patients report improvements in confidence, social comfort, hairstyle choices and self-image following surgery.

For children, otoplasty can also reduce the emotional impact of teasing or bullying related to prominent ears.

Results from an otoplasty are generally long lasting. However, minor asymmetries are normal, cartilage has some memory, and subtle relapse can occasionally occur over time.

What kind of recovery can I expect?

Recovery after an otoplasty is usually straightforward, but the ears do need careful protection while they heal.

Most patients experience mild to moderate discomfort, tightness, throbbing or tenderness during the first few days. Pain is usually managed with paracetamol, anti-inflammatory medication and occasionally stronger pain relief if required.

Swelling and bruising are expected to improve over several weeks. At first, the ears may appear swollen, slightly overcorrected or uneven. This generally settles as healing progresses. Temporary numbness or sensitivity around the ears is common during the first few weeks.

Scars are usually hidden behind the ears and tend to heal very well. Scar maturation continues for around twelve months. Scar care may include silicone therapy, scar massage and sun protection, although visible scarring after otoplasty is uncommon.

A protective head dressing is usually worn for the first week. After this, a supportive headband is commonly recommended during sleep for several weeks to protect the ears while they heal.

Protecting the ears from pressure or accidental bending during the early healing phase is important to help maintain the surgical result.

Follow-up appointments are scheduled throughout your recovery, and Dr Cameron is happy to review you at any stage if you have concerns.

As a general guide, most patients are able to return to regular activity as follows:

  • School or desk work: approximately 1 week
  • Walking and light activity: within the first few days
  • Light exercise: around 2 weeks
  • Gym: around 4 weeks
  • Contact sport or activities risking ear trauma: at least 6 weeks
  • Driving: usually several days to 1 week for adult patients, provided you are not taking sedating pain medication and feel safe to drive.
Are there any risks or potential complications?

All surgery carries some degree of risk. These risks are reduced through careful preparation, surgical planning, post-operative care, and the experience and judgement of Dr Cameron and the Morphē Clinic team.

General risks associated with facial surgery will be discussed with you before your procedure.

Risks specific to otoplasty may include:

  • Asymmetry. Minor asymmetry is common and perfect symmetry is not achievable. Pre-existing asymmetry may persist after surgery.
  • Recurrence or relapse. Some recurrence of ear prominence can occur over time due to cartilage memory and individual healing characteristics. Revision surgery is occasionally required.
  • Overcorrection. In some cases, the ears may appear too pinned back or flattened. Careful planning aims to minimise this risk.
  • Scarring. Scars are usually well hidden behind the ears. Thickened or visible scarring is uncommon.

Risks specific to otoplasty may include: (cont.)

  • Suture problems. Permanent internal sutures are commonly used to reshape the ear. Rarely, these may become palpable, visible or infected, and suture removal may be required.
  • Infection. Infection involving the ear cartilage is uncommon but important. Early treatment is needed to protect the shape of the cartilage.
  • Altered sensation. Temporary numbness or altered sensation around the ears is common and usually improves over time.
  • Cartilage irregularity. Minor contour irregularities may occasionally occur. Revision surgery is sometimes required.
  • Haematoma. Bleeding beneath the skin can occur and may require drainage.
  • Need for revision surgery. Small revisions are occasionally required for asymmetry, recurrence or contour refinement.