The auricle may be disproportionately large relative to the face, the conchal bowl may be deep, or incomplete folding of cartilage may make the ear stand farther from the head. These features may occur together or alone and can affect facial appearance.
The earliest age generally considered for surgery is 5–6 years. Operating before school age may reduce teasing. The procedure can also be performed in adults; with age, cartilage stiffens and shaping may become more difficult.
In children otoplasty is performed under general anaesthesia; in adults regional anaesthesia may be used if preferred. The most frequent indication is incomplete antihelical fold, with or without a deep conchal bowl. An incision is made behind the ear, skin is elevated, and non-absorbable or slowly absorbable sutures create a fold; excess cartilage may be removed. The incision is closed with fine sutures. A firm dressing is applied for the first day. The operation usually lasts about one to one and a half hours.
Hospital stay is not required. Daily activities may resume from the second day. After the first-day dressing, a looser band is worn for 7–10 days, then at night for at least one month. Postoperative pressure from the dressing is usually managed with ordinary pain relief. Because the incision lies in the post-auricular crease, a visible scar is not expected if there is no suture reaction.
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