Otoplasty — the one operation in this layer that children often have

Otoplasty corrects ears that sit far out from the head, commonly called prominent ears.

First, what the operation does. There are usually two causes.

• the fold in the ear cartilage (the antihelix) has not formed enough — the fold is created
• the bowl of the ear (the concha) is deep and pushes the whole ear out — its depth is reduced

The methods also fall into two groups: shaping the cartilage by scoring or carving it, and folding and holding it with sutures alone. How far they come undone differs. See below.

The incision goes behind the ear. That is why this site marks the scarring as hidden. It does not show from the front.

And this page carries a question the other pages in this layer do not.

Children often have this operation. Ears reach nearly their full size early, so it can be done younger than work on other areas. Which attaches a question here that attaches nowhere else — whose wish is it.

This site does not deal in prices, clinics or reviews.

It can come undone. This is the operation's characteristic problem. Cartilage tends to return to its original shape, so especially where it has only been folded with sutures, those can loosen or one side can drift back over time. Ask before surgery which method will be used and how often it comes undone.

Haematoma is the most urgent complication. Blood collecting between the ear cartilage and the skin can damage the cartilage and change the shape permanently. If one ear alone is severely painful or swells after surgery, report it immediately — at night too.

Infection is urgent for the same reason. Infected cartilage loses its shape.

The two sides will not end up identical. Ears differ in shape and position to begin with. And after surgery you will be looking at that difference more often.

The shape can end up unnatural. Pinned back too far, the ear looks pressed against the head from behind; a fold made too sharply shows as a hard line.

Sensation is dull for a while. It usually returns.

If your scars tend to thicken, they do so behind the ear too. Say so first if you have a history of keloid. The ear is a site where keloids form readily.

A headband is worn for weeks afterwards, to stop the ear being pressed or folded during sleep. Care in this period bears directly on the result.

For a child, establish whose wish it is first. That is the most important sentence on this page.

A child who is troubled by it and wants it is not the same as a parent who wants it. Talk about which it is in the consultation. Look too at whether the child is old enough to understand the operation and the recovery.

Timing is to be discussed with clinicians. Ears reach nearly full size early, so it can be done younger than work elsewhere. But 'it can be done' and 'it should be done now' are different sentences. Weigh alongside it that waiting lets the person decide for themselves.

Adults often have it under local anaesthesia; children generally need a general anaesthetic. The anaesthesia line in the table above is for adults.

Ask which method will be used. Working the cartilage and using sutures alone come undone to different degrees.

Even if only one ear stands out, look at both together. Doing one side alone sometimes makes the difference more visible.

Check in advance how long the headband is worn. It is measured in weeks, and wearing it during sleep especially matters.

Explain the limits on sport and play to a child in advance. A knocked or folded ear is the biggest risk early in recovery.

This operation cannot be undone. Cartilage carved or folded and fixed does not go back. Part of it drifting back against intention is a separate matter, covered under cautions above.

One more thing about operating on children. This site does not push judgements on its surgery pages. But an operation done at an age where the person cannot yet state their own decision carries a weight the other pages do not. Writing that weight down is what this site can do.

Judge the result from behind as well. This operation is hard to assess from the front alone. Look at it from behind and from above too.

It keeps settling for months after the swelling goes and the band comes off. Give it three to six months.

Whether to have it done is settled with a doctor, and it is better not to settle it on one consultation alone.