What is otoplasty?
Otoplasty is the general name for surgery that changes the shape, size, symmetry or position of the outer ear (the auricle). It is not a single operation but a family of techniques, ranging from repairing a split earlobe to unfolding a rim that has been folded since birth.
The outer ear is made of flexible cartilage covered by thin skin, with a characteristic pattern of folds. The proportions of these folds, the overall size of the ear and how it relates to the face determine how the ear looks. The aim of otoplasty is an ear that does not draw attention: balanced with the other side and natural in appearance.
Ears that stick out too far from the head are the most common reason for ear surgery. We cover this in detail on our dedicated page on prominent ear correction; this page focuses on the other conditions that ear reshaping surgery can address.
Which ear problems can otoplasty correct?
Conditions we frequently see in clinic and that can be improved surgically include:
- Torn or elongated earlobes caused by heavy earrings, an earring being pulled, or a piercing that has gradually widened over the years.
- Stretched earlobes after gauges or tunnels, where the lobe has become a large loop.
- Large or droopy earlobes that look out of proportion with the face.
- Macrotia – an ear that is large overall in relation to the face.
- Constricted, lop or cup ears – congenital shapes where the upper rim folds forward or the ear is narrower than usual.
- Stahl's ear – an extra cartilage fold in the upper ear, giving the rim a pointed look.
- Noticeable asymmetry in size, shape or position between the two ears.
- Deformities after injury, such as bites, lacerations or the thickened "cauliflower ear" seen in contact sports.
- Revision of previous ear surgery.
When all or most of the ear has not developed (microtia), a separate, multi-stage reconstructive plan is required.
How is torn or stretched earlobe repair done?
Earlobe problems are the shortest and most frequently performed part of otoplasty. For a split lobe, the healed skin edges of the tear are refreshed and the front and back surfaces of the lobe are closed in layers. Planning the scar as a slightly broken line rather than a straight one can help reduce the risk of a small notch forming later.
After gauges, excess tissue is removed and the remaining tissue is rearranged to recreate the natural rounded contour of the lobe. Large or droopy lobes are reduced by removing a wedge of tissue from the edge or the back of the lobe.
These procedures are usually performed under local anaesthetic, take around 30–60 minutes, and you go home the same day. Stitches are generally removed after 7–10 days.
Correcting large, folded and asymmetric ears
When the ear cartilage itself is involved, each ear receives an individual plan. The main approaches are:
Ear reduction
In macrotia, a measured amount of skin and cartilage is removed from the outer rim (helix) and the adjacent groove (scapha) to shorten the ear. Incisions are placed along the inner edge of the rim so that they are well concealed. The earlobe can be reduced in the same session if needed.
Lop and constricted ears
If the upper rim is folded forward, the cartilage is released, reshaped and, where necessary, supported with a small piece of cartilage taken from elsewhere in the ear. More pronounced constriction may need more extensive techniques to add tissue to the upper part of the ear.
Stahl's ear and asymmetry
In Stahl's ear, the extra cartilage fold is weakened or removed and the natural curve of the rim is restored. For asymmetry, the goal is for both ears to look as similar as possible; sometimes this means operating on one ear only, sometimes on both to different degrees.
In newborns with congenital ear shape differences, moulding techniques applied while the cartilage is still very soft can sometimes avoid surgery altogether. We explain this further on the prominent ears page.
Ear surgery after injury and revision otoplasty
The outer ear is one of the most exposed parts of the face and is easily injured by blows, bites and cuts. In contact sports, a blow to the ear can cause blood to collect between the skin and cartilage. If this is not drained early, the cartilage thickens and a permanent deformity can develop, so we recommend seeking assessment promptly if your ear swells after an injury.
In established post-traumatic deformities, the thickened cartilage is thinned and the contours of the ear are rebuilt. Where tissue has been lost, surrounding tissue or cartilage grafts may be used, and larger defects may need repair in more than one stage.
Revision surgery is for patients who have had ear surgery before and experience problems such as the ears moving forward again, over-correction, sharp cartilage edges or asymmetry. Because the tissues have already been altered, these operations require more detailed planning.
Consultation and preparation
At the first consultation we listen to what bothers you about your ear, then assess the cartilage structure and flexibility, skin quality and the differences between the two sides. As part of a full ENT examination, the ear canal and eardrum are also checked. Photographs from several angles are taken for planning.
Before surgery:
- Your medication, particularly blood thinners and herbal supplements, is reviewed.
- If general anaesthesia is planned, routine tests and an anaesthetic assessment are carried out.
- If you smoke, you will be asked to stop for a period, as smoking impairs wound healing.
- If you have had previous surgery, your operation notes and old photographs help with planning.
If you are travelling from abroad, much of this can be discussed in advance by email or video consultation, and the consultation itself can be held in English.
Recovery after otoplasty
Recovery depends heavily on the extent of surgery. Patients who have only an earlobe repair often return to normal activities the next day, whereas cartilage surgery requires a longer recovery.
| Time | Typical course after cartilage surgery |
|---|---|
| First 2–5 days | A protective dressing stays in place; mild pain and tightness are usually controlled with painkillers. |
| Week 1 | The dressing is removed and the ear is checked; a soft headband for night-time use is recommended. |
| Days 7–14 | Non-dissolvable stitches, if used, are removed; most people return to desk-based work. |
| Weeks 4–6 | Night-time headband use usually ends; light exercise can be resumed. |
| Months 3–6 | Swelling and numbness along the rim largely settle, and the final shape becomes apparent. |
We see patients in the first week, at one month and at three months. For patients who live elsewhere, interim follow-ups can be carried out by video call.
Risks and what to watch for
Otoplasty is generally considered a safe procedure, but like any surgery it carries risks. These include bleeding and a collection of blood under the skin (haematoma), infection and inflammation of the cartilage lining, stitches that can be felt or work their way out, asymmetry, thickened or raised scars (keloid), temporary reduced sensation and sensitivity to cold. Some patients may need a minor touch-up later on.
Increasing or one-sided pain, marked swelling or a fever in the first few days after surgery need prompt assessment, so please contact us straight away if you notice them.
Can ear surgery be combined with other facial procedures?
The ears are part of facial proportions, and some patients consider ear surgery alongside other procedures. For example, earlobe repair or reduction can be planned in the same session as rhinoplasty. Earlobes that look pulled down after a facelift can also be corrected with otoplasty techniques.
Whether procedures should be combined depends on operating time, your general health and how you would like to plan your recovery, and we decide this together. For an overview of how the face is assessed as a whole, see our facial aesthetics page.
The information on this page is for general guidance only and does not replace diagnosis or treatment. The right treatment for you can only be decided after an examination, and results vary from person to person.