Otoplasty: What it corrects in the ears and what it does not change

Otoplasty is the surgery that reshapes the ear cartilage to bring it closer to the skull or to correct folds that did not form. It does not change the size of the face, it does not “glue” the ear to the bone, and it is not a substitute for an assessment when the problem is related to hearing. In consultation, the usual question is not whether surgery is possible, but which part of the relief can be modified and which should be left as it is.

In Spain, “otoplastia” accounts for about 4,400 monthly searches (DataForSEO, Spain market, Spanish, October 2026 update). “Orejas de soplillo” (prominent ears) adds nearly 1,000. The interest exists. The indication does not: it depends on the cartilage, the age, and what the patient expects to see in the mirror.

What anatomical problem it addresses

Prominent ears are usually due to one of two things, or both at once. The antihelix has not folded enough, and the concha is too deep, so the auricle projects outward. Sometimes a detached lobe or asymmetry between both sides is added. It is not a skin defect. It is cartilage.

That is why otoplasty acts on the cartilaginous skeleton: it folds what is missing, reduces the projection of the concha if necessary, and fixes that new shape with permanent sutures, usually behind the ear. The scar remains in the retroauricular groove. It does not disappear. It remains hidden in most hairstyles and haircuts.

What it does not correct: it does not reduce a large ear in all its dimensions if the patient asks for “small ears” without a partial reduction plan. It does not match two ears that were born different to the millimeter. It does not treat hearing loss, earwax plugs, or otitis. These problems belong to the otolaryngologist, not to this surgery.

Adults and children: the timing is not the same

The auricular cartilage reaches almost its adult size by age five or six. From that age, in selected cases and when the child asks for it (not just the family), surgery can be considered. Before then, except for very specific reconstructive indications, waiting is usually the most sensible decision.

In adults, the cartilage is more rigid. The technique is adapted: sometimes it is necessary to weaken the cartilage so that the new fold is maintained, not just place sutures. Social recovery is similar—a few days with a headband and several weeks without contact sports—but the motivation and ability to follow instructions are not those of a child. That is why an article on otoplasty in adults or on when to operate in childhood does not cover this question: here the focus is what can be changed and what remains.

What can be expected, and what cannot

The clinical goal is a less projected ear, with a more defined fold and a proportionate appearance relative to the other. It is not a “new” ear. The helix, the lobe, and the insertion into the scalp remain those of the patient.

• The distance between the edge of the ear and the mastoid can be reduced, within what the cartilage allows.
• An antihelix that did not exist or was very flat can be defined.
• Absolute symmetry cannot be guaranteed. Ears are not twins, neither before nor after.
• It cannot be promised that no one will notice the surgery. A natural result is less noticeable. It is not invisible by decree.

In a minority of cases, sutures can extrude or be felt under thin skin. The cartilage can regain some of its memory, and the projection may increase by a few millimeters over the months. This is why follow-up does not end when the headband is removed. These are known limits of the technique, not failures of a specific case, and they are discussed during the assessment, not in a brochure.

How it is planned in consultation

The visit measures the projection, looks at the antihelix and the concha, and compares both sides with the patient seated, not just in photos. The patient is asked what bothers them: the relief seen from the front, from the side, with hair tied back, or both ears equally. That answer changes the plan more than any isolated measurement.

Causes that are not operated on with an otoplasty are also ruled out: a lobe torn by an earring, a previous scar, or a malformation that requires reconstruction rather than just a fold. If the expectation is “so that my ears can’t be seen,” it must be stated clearly: the surgery brings the auricle closer. It does not hide it behind the head.

At Mallorca Medical Group, this assessment is performed by Dr. José Ignacio García Ceballos, a specialist in plastic, reconstructive, and aesthetic surgery, with MRCS I England accreditation and 25 years of clinical practice. The consultation is not free. It serves to decide if otoplasty is indicated, if it is better to wait, or if the problem is not surgical.

Recovery, in one useful sentence

During the first few days, there is swelling and a headband that maintains the new position. Sleeping on the side of the operated ear is avoided for several weeks. Contact sports and helmets that compress the auricle are also avoided. The result is judged when the edema subsides, not at 48 hours. The week-by-week detail of recovery is already covered in another post on this blog. Here, it is enough not to confuse early inflammation with the final result.

When not to operate

It is not indicated if the patient (or, in the case of a child, only the adult) seeks a change that the cartilage cannot provide. Nor if there is an active external ear infection, an expectation of perfect symmetry, or the idea that surgery will resolve an insecurity not located in the ear. In those cases, saying no is part of the clinical criteria.

If the question is whether otoplasty corrects prominent ears, the short answer is: often yes, when the problem is one of projection or folding, and no when a different ear from the one you have is requested. The decision is made in consultation, with measurements and photos, not with a search engine.

To request an appointment: mallorcamedicalgroup.com or call 971 254 686. Mallorca Medical Group, Camí Vileta 46C, Palma.