Otoplasty aftercare in children, sorted for parents: school, headband, sport and summer

The headband is worn twenty-four hours a day for the first five days and then, for nine more days, only for sleeping and while at home. They do not go to school in it. That is the answer to the question we are asked most in clinic, and almost all the logistics of the following fortnight hang from it.

The rest is organisation: a week off school, a few reviews, sport in stages and a short list of things to watch for at home. None of it is complicated, but it is much easier to handle knowing it before going into theatre than discovering it on day two.

This page covers only what is specific to a child and to family organisation. The general timings of the operation are in the otoplasty guide, and if you are still deciding, in the guide to making the decision.

The headband: what it does and how long it is worn

It is the part of the recovery that takes up most of families’ attention, so it is worth understanding rather than simply complying with.

What it does. The result is held by the internal sutures that have folded the cartilage, not by the headband. What the headband does is protect that work while it heals: it spreads the pressure, stops a knock or the pillow pulling on the ear, and reduces swelling. Put another way, it corrects nothing by itself, but it stops what has been corrected from being spoilt.

How long it is worn, in our protocol:

• Days 0 to 5: twenty-four hours a day. For sleeping too. This is the strict stretch.
• Day 5: review. From then on the headband is worn only for sleeping and while at home.
• Days 6 to 14: nine more days like that. Out in the street, at school or at the park, they go without it.
• Day 14: it comes off.

How to get them to wear it. The first five days are the hard ones, and with a child tricks work better than orders:

• Show it to them before the operation and let them try it on. What is not a surprise is better accepted.
• Let them choose something: which end of the sofa, the film, the pillow. The headband is not negotiable, but the rest is.
• Have two, so one can be washed without leaving any time without it.
• Check it is not too tight. It should hold, not mark the skin. If it leaves a mark or is persistently uncomfortable, tell us: a headband that is too tight is worse than a loose one.
• Once the five days are over, the problem disappears. Knowing that the hard stretch has an end date helps everyone, parents included.

If it comes off one night while they are asleep, which is the most common thing of all, nothing has happened: put it back on and mention it at the review. The harm of one night without it does not compare with the anxiety of watching a seven-year-old sleep.

How many days off school

Around a week. That is the usual approximate figure and it matches the reference given by the Spanish Society of Plastic, Reconstructive and Aesthetic Surgery.

What usually reassures families is the second part: when they go back, they are no longer wearing the headband. Going back to school is not “the child with a band round their head for a month”, which is the picture many parents bring with them from the past. They go with their hair normal and with instructions to avoid being shoved or hit by a ball, which is different from being singled out.

It is worth telling the school two things: that for a few weeks they must not be hit on the head and that in PE they are on restrictions. No more detail is needed, and form tutors appreciate it.

When to operate: summer, Christmas or a long weekend

All three work, and the choice is a matter of the family calendar rather than a medical one:

• Summer. The most popular: no time missed at school and plenty of margin. Against it, the heat under the headband in the first five days and the sun, which has to be kept off the scar. And swimming, which is out until the fourteen days are up.
• Christmas. Two weeks of holiday cover almost exactly the full headband cycle. It is probably the cleanest window.
• A long weekend or Easter. It covers the 24-hour stretch and part of the rest; they go back to school in the easy phase.

Book the assessment months in advance. The pre-operative consultation, the theatre date and the reviews cannot be organised in a fortnight, and a lot of people ask for the school holiday windows at the same time.

The pain, and what you can give them

The pain from this operation is moderate and lasts only a few days. In the published series, pain scores in the first few hours are low: a systematic review of pain management in otoplasty describes mean scores at six hours of 0.25 with a regional nerve block and 2.34 with local infiltration, out of 10.

What is common, and worth anticipating, is that the child complains of itching, tightness or the ear feeling odd for weeks. That is expected and it passes.

On medication, one rule only: whatever you are prescribed on discharge, at the dose you are prescribed. A child’s weight changes the dose, and a web page cannot know theirs. Do not adjust it yourselves and do not add anything without asking.

PE, football, judo and taekwondo

The return to sport is gradual, and the criterion is the risk of something pulling on the ear or striking it:

• First month: gentle activity. Running, walking, playing without contact. PE with restrictions, having told the teacher.
• From six weeks to three months: contact sports. Football, basketball, martial arts, rugby. They are the last to resume, and the exact date is set by the surgeon at the review.
• Judo, taekwondo and wrestling deserve a separate mention: they pull on the ear more than anything else and they are the most delayed. If your child competes, say so at the consultation before fixing the date, because it may shape the calendar.

Swimming pool, beach and sun

• Swimming pool and sea bathing: from day 14, when the headband comes off. Not before: pool water and sea water are not sterile, and the area behind the ear is delicate while the wound has not fully closed.
• Sun on the scar is the enemy of the following year. A recent scar exposed to the sun becomes pigmented and takes far longer to fade. A cap, hair worn down or high protection, and for months rather than weeks.
• The heat under the headband in the middle of August is uncomfortable and it is the number one complaint of summer operations. It is not dangerous, but it is worth saying beforehand.

How to wash their hair in the first few days

Their hair can be washed from the third day after surgery. Not on the first two.

After that, washing backwards works well, with the child lying face up and their head over the edge, as at the hairdresser’s: you control the water, it does not run down their face and the operated area gets only as wet as it needs to. Gently, and without rubbing behind the ear.

No hot hairdryer near the ear: sensation is altered and they may not feel the heat.

What to watch for at home, and when to ring

This is what really matters on the whole page, so it is set out as clearly as possible.

Normal in the first few days: swelling, some bruising, discomfort that settles with the prescribed painkillers, itching and a feeling of tightness.

Ring the clinic without waiting for the review if any of this appears:

• Pain that increases rather than settling, particularly if it starts from the second or third day.
• Redness and swelling that appear or worsen after the first 48-72 hours.
• Fever.
• Discharge or a bad smell.
• One ear swelling abruptly and far more than the other.

The reason for insisting on when each thing appears is that timing guides us: what sets in very early suggests a haematoma, whereas the late pattern points more towards an infection of the cartilage — perichondritis — which is uncommon but is the complication that worries us most because it can deform the ear. Seen early, it is managed well.

It is also worth telling us, without urgency, if a stitch works its way out or a small lump is felt in the area of the sutures: it is the most frequent complication in the published series — suture extrusion, at around 5.4% — and it is dealt with in clinic.

The reviews

The usual pattern is one review at around the fifth day, which is when the headband regime changes, and another when it comes off altogether, at around day 14. After that, whatever the surgeon considers necessary to follow the scar and the shape, bearing in mind that the result is not judged until six months, once the swelling has completely gone.

Frequently asked questions

How many days off school does a child need after an otoplasty?

Around a week, as a guide. When they go back they are no longer wearing the headband: from day 6 it is only used for sleeping and while at home.

How long does the headband have to be worn?

Fourteen days in total, in two phases: twenty-four hours a day for the first five days and then nine more days only for sleeping and while at home. The timings are approximate and the surgeon confirms them at the reviews.

And if my child cannot stand the headband or takes it off while asleep?

That is the most usual thing of all and it is not a catastrophe. Put it back on and mention it at the review. It helps to show it to them before surgery, to have two so they can be washed, and to check that it holds without marking the skin. The strict stretch is only five days.

When is the best time to operate: summer, Christmas or a long weekend?

All three work. Christmas is usually the cleanest window because two weeks of holiday cover almost the whole headband cycle; summer gives more margin but adds heat, sun and swimming. Either way, book the assessment months in advance.

What pain will they have and what can I give them?

Moderate pain lasting a few days, which responds well to painkillers. The medication is whatever you are prescribed on discharge and at the dose you are prescribed: it depends on the child’s weight and is not adjusted by yourselves.

When can they go back to PE? And to football or judo?

Gentle activity from the first month; contact sports between six weeks and three months. Judo, taekwondo and wrestling pull on the ear most and are the most delayed: if they compete, it is worth saying so before fixing the theatre date.

Can they go to the pool or the beach that summer?

From day 14, when the headband comes off. And when they can, with the scar protected from the sun: a recent scar that burns takes many months to fade.

How do I wash their hair in the first few days?

From the third day after surgery; not on the first two. Lying face up with their head over the edge, as at the hairdresser’s, is the easiest way to control the water. Without rubbing behind the ear and with no hot hairdryer nearby.

What do I watch for at home and when do I ring?

Ring without waiting if the pain increases rather than settling, if redness appears or worsens after 48-72 hours, if there is fever or discharge, or if one ear swells abruptly and far more than the other. What appears late is more worrying than what appears on the first day.

How many reviews are there?

Usually one at around the fifth day, when the headband regime changes, and another when it comes off at around day 14. After that, whatever the surgeon advises to follow the scar.

When will the definitive result be visible?

The shape is visible from the first moment, but the result is not judged until the swelling has completely gone, at around six months.

Sources

• Spanish Society of Plastic, Reconstructive and Aesthetic Surgery (SECPRE). Cirugía de las orejas. secpre.org — Approximate figure of around seven days before returning to school, and general criteria for recovery in children.
• Alnufaei AH, AlSubaie FK, Aljabri RA, et al. Perioperative Analgesia and Postoperative Nausea and Vomiting Management in Otoplasty: A Systematic Review. Plast Reconstr Surg Glob Open. 2026;14(2):e7347. PMID 41705217 — Mean pain scores at six hours of 0.25 with a regional nerve block against 2.34 with local infiltration. Source of the postoperative pain figures.
• Kaleeny JD, Janis JE. Otoplasty Surgical Techniques and Clinical Outcomes: A Practical Review. Plast Reconstr Surg Glob Open. 2026;14(1):e7404. PMID 41567352 — Meta-analysis of 18 studies and 1,590 patients: suture extrusion (5.4%) is the most frequent complication. Supports the warning about stitches working their way out.
• Sadhra SS, Motahariasl S, Hardwicke JT. Complications after prominent ear correction: A systematic review of the literature. J Plast Reconstr Aesthet Surg. 2017. PMID 28602268 — 28 studies and 3,493 patients: haematoma or bleeding 2.5%, healing problems 1.6%, infection 0.8%.
• Otoplasty. StatPearls, NCBI Bookshelf. NBK538320 — Distinguishing haematoma from perichondritis by when they appear, which is the criterion used in the warning-signs section.
• Carvalho C, Marinho AS, Barbosa-Sequeira J, et al. Quality of life after otoplasty for prominent ears in children. Acta Otorrinolaringol Esp. 2023;74(4):226-231. PMID 36427795 — 55 children with a median age of 7.7 years; 96% of parents would recommend the surgery.

Book your consultation

If surgery is already decided and what you are missing is how to fit it into the school year, that is sorted out in clinic: we look at the date that suits you, count the headband cycle day by day and tell you which week they will miss at school and when they can go back to the sport they play.

The assessment is done with the child present and with both parents, and it also deals with what worries them, which is almost never the same as what worries you.

Clinical confirmation by the surgeon

Dr Enrique Salmerón González

Specialist in Plastic, Aesthetic and Reconstructive Surgery
Registration no. 46/4624077

Dr Elena García Vilariño

Specialist in Plastic, Aesthetic and Reconstructive Surgery
Registration no. 46/4624503

Last reviewed: 17 September 2026. This content is for information only and does not replace an individual assessment by a healthcare professional.