Children with excessively protruding ears often suffer deeper emotional upsets than are generally realized by their friends or parents. Typically, teasing starts when the child begins school (at approximately six years of age). Frequently, this teasing consists of nicknames that can be surprisingly cruel. For this reason, we recommend that otoplasty be carried out before the child reaches school age. At about this time the ears have reached approximately 90 percent of their adult size, so little growth of the ear occurs after this time. As with the remainder of the face, each ear develops separately, as does each side of the face. For this reason, preoperative asymmetries in ear position are very common.

During the development of the embryo, the ears initially project straight out from the head. As time goes on, the ears assume a more normal position, becoming relatively flat to the head.

In patients who have abnormally projecting ears, this latter aspect of the development of the ear failed to occur. The procedure known as otoplasty is simply a surgical procedure that completes this developmental process by repositioning the ears closer to the head. Occasionally, when the ear cartilage is thick and strong, it may resist being repositioned, and a smaller tuck procedure may be required approximately six months after surgery.

For younger children, a general anesthetic is usually required , but the patient most often goes home on the day of surgery. Older patients can have the procedure with the use of twilight anesthesia in the clinic operating room, also going home on the day of surgery. Usually the pain after this type of surgery is minimal.

The scars that result from this procedure are usually well hidden behind the ears. Rarely, the scars may show signs of enlargement, which can usually be softened by cortisone. Occasionally a scar revision or revision otoplasty will be required.

Patients suffering from microtia (small ears) or congenitally absent ears require a more extensive reconstruction. Usually, rib cartilage is sculpted to provide the framework, and multiple stages of reconstruction are often required to achieve success.