The Condition
Prominent ears result from underdevelopment of the antihelical fold, excess conchal cartilage, or a combination. They are common (approximately 5% of the population) and often have a significant psychological impact, particularly in children. Otoplasty is generally recommended from age 5–6, once the ear has reached approximately 85% of its adult size, though it is equally effective in adults.
Surgical Options
Antihelical fold creation: The most common technique. The antihelical fold is created or enhanced by scoring, suturing or reshaping the cartilage (Mustardé sutures) to produce a natural-looking fold.
Conchal reduction: Reduction of the bowl of the ear when conchal excess contributes to prominence.
Combined techniques: Most cases require a combination of the above, tailored to the individual anatomy.
Mr Naparus performs paediatric otoplasty at The Portland Hospital and Chelsea & Westminster Hospital Private Care. He is known for his calm, gentle approach with children and their families, ensuring a positive and anxiety-free experience.
Who Is a Good Candidate?
Most children and adults with prominent ears are suitable candidates, but not everyone needs — or should have — surgery. In children, the decision is guided by the degree of psychological impact and the family's own wishes, not simply the presence of prominence.
Indications: Prominent ears causing self-consciousness, teasing or psychological distress in children; adults seeking correction who were not treated in childhood; sufficient ear cartilage maturity (from around age 5–6).
Contraindications: Very young children where the ear has not yet reached sufficient size; active ear infection; unrealistic expectations of perfect symmetry, given some natural asymmetry is normal and expected.
The Procedure
Children: general anaesthesia. Adults: local anaesthetic or sedation — Mr Naparus is experienced in performing this procedure under local anaesthetic comfortably. Incision behind the ear in the natural crease. Operating time 1–2 hours. Day-case procedure. A head bandage is worn for one week.
Risks & Complications
Haematoma
2–5%. Head bandage worn for 1 week reduces risk. Requires drainage if significant.
Infection / Perichondritis
<2%. Prompt antibiotic treatment required. Prophylactic antibiotics given.
Asymmetry
Minor asymmetry expected and common; significant asymmetry requiring revision uncommon.
Suture Extrusion
3–5%. Sutures may work their way to the skin surface; usually managed simply in clinic.
Over-correction
Telephone-deformity (over-pinned appearance); avoided by conservative technique.
Recurrence
Partial recurrence over years possible; usually requires no intervention.
Aftercare & Recovery
- Head bandage worn for 7 days; then softer headband at night for 4–6 weeks
- Shower after 48 hours; keep ears dry until healed
- Sutures (non-absorbable) removed at 10–14 days
- Return to school/office work: 7–10 days
- Exercise: light activity at 2 weeks; avoid contact sports for 6 weeks (important in children)
- Swimming: 3–4 weeks after healing
- Avoid activities risking ear impact for 6 weeks
Alcohol impairs platelet function, increases bleeding risk, interferes with anaesthesia, and impairs wound healing. Abstain for at least two weeks before and after surgery.
Face sutures removed at 5–7 days; body sutures at 10–14 days. Absorbable sutures require no removal. You will be clearly advised which type has been used.
Micropore tape reduces scar tension. Silicone tape/sheets commence at 2–4 weeks. Prineo mesh dressing used for longer incisions. Avoid direct sun on scars for 6 months; SPF50+ mandatory.