In short
- The first condition is that the child asks for it. That is SECPRE’s criterion and it is ours.
- From the age of 5 or 6 is the usual reference: by then the ear has reached 80-90% of its adult size.
- The evidence is good: in a Spanish series of 55 children, quality of life clearly improved and 96% of parents would recommend the surgery to others.
- There is no hurry. Except in the newborn, where there is a window of a few weeks to mould without surgery, here the margin is years.
- And there is one risk worth naming: a badly done otoplasty can weigh emotionally more than the original problem.
- That risk is not the same with every technique: it is higher with those that cut or score cartilage than with suture techniques.
- Complications are uncommon, and the most usual is needing a revision — at around 5%.
There is one condition that comes before all the others, and that settles more cases than anatomy does: the child has to want the appearance of their ears changed. That is not a pleasantry — it is the criterion set out by the Spanish Society of Plastic, Reconstructive and Aesthetic Surgery itself, and it is the one we apply. We do not operate on a child who does not want surgery. When the motivation belongs only to the parents, the sensible thing is to wait.
That said, when the child does ask, the evidence is supportive: studies measuring quality of life with validated questionnaires find significant and lasting improvements. This page gathers what is known, what to look for at home and what is worth asking in clinic before saying yes.
This page develops the family decision that the pillar page settles as an age criterion: the otoplasty guide.
The condition that comes first
A seven-year-old who arrives saying they do their hair to cover their ears, who avoids photographs or who asks whether they can be “fixed”, is expressing a request of their own. A child brought in by their parents who shrugs is not.
The difference is not an ethical nicety: it changes the result. Someone who has not asked for the change does not experience the recovery as their own, and the experience is more likely to feel like an imposition than a relief.
That is why the assessment always involves both parents and the child themselves. In minors, the decision legally rests with those holding parental responsibility, taking the child’s opinion into account according to their maturity — and here that opinion counts for a great deal.
Why from the age of 5 or 6
The reason is anatomical. By that age the ear has reached around 80-90% of its adult size, so later growth does not compromise the correction. SECPRE puts the point from which it can be considered in children at 6 years.
Before that age there is no advantage in going early — with one exception that has nothing to do with surgery: in the first few weeks of life the cartilage can still be moulded without operating, and that window really does close. If your child is weeks old rather than months, that is the page you want.
What the evidence says about operating on a child
There are figures here, and they are better than many parents expect.
A Spanish study of 55 children who had surgery, with a median age of 7.7 years, measured quality of life with validated questionnaires — the paediatric quality of life inventory, answered by the child and by their parents, and an adaptation of the Glasgow Children Benefit Inventory. The result was a clear improvement in quality of life after surgery, and 96% of parents said they would recommend it to other families. Dissatisfaction with appearance was the main negative experience beforehand.
A review of otoplasty and quality of life reaches the same conclusion from further back: several studies using validated tools show that otoplasty produces a significant and lasting increase in health-related quality of life, in both children and adults with prominent ears.
And the context: prominent ears affect around 5% of the population and can have a significant psychological impact. It is not a rarity, and it is not trivial.
The uncomfortable point about expectations
The Spanish study found something worth reading twice: previous bullying and high parental expectations about the change surgery would bring both predicted higher benefit scores.
The first part is expected and reassuring: those who were having the hardest time are the ones who gain most.
The second invites caution. Benefit was measured with a questionnaire answered by the parents themselves, so those who expected a lot tended to report having got a lot. It does not say that surgery works better with high expectations; it says that expectation influences how the result is perceived.
The practical reading is straightforward: expectations are worth discussing before surgery, and above all separating what surgery changes — the shape of the ears — from what it does not change by itself: a child’s confidence, their place in the class or their relationship with a group that has picked on them.
Signs that it is genuinely affecting them
What does point that way:
- They style their hair to cover them, always wear their hair long or habitually wear a hat.
- They avoid photographs, the swimming pool, the hairdresser or sports with a helmet.
- They say so: they ask, they compare themselves, they say they do not like them.
- They have had comments at school repeatedly.
What is not a sign in itself:
- That the parents are worried. That is legitimate, but it is not an indication.
- That it shows in photographs. Plenty of prominent ears do not bother their owner.
- That a relative has commented on it. It is the most frequent route by which a child starts noticing something they had not registered.
What to know before saying yes
The honest conversation includes this, and it is better had beforehand.
Complications are uncommon. The largest systematic review published, pooling 28 studies and 3,493 patients, puts reoperation or recurrence at around 5% — the most frequent — haematoma or bleeding at 2.5%, suture problems at 1.8%, healing problems at 1.6% and infection at 0.8%.
And there is one risk that does not appear on those lists. A review of quality of life puts it bluntly: irreversible deformities after a failed otoplasty can be more emotionally draining for the patient than the situation before surgery. It is the most important sentence on this whole page, which is why it is here and not buried at the end.
That risk depends on the technique. That same paper notes that it is higher with techniques that score or cut the cartilage than with those based on sutures alone. It is a legitimate question to ask in clinic.
Translated into a parental decision: otoplasty is an operation with good results and a low rate of problems, but it is not reversible, and that is why haste never works in your favour.
How to raise it at home
- Let the question come from them. There is no need to force it; it is enough not to shut it down when it appears.
- Do not turn it into a defect. A child who repeatedly hears that they have a problem ends up having one.
- Separate the cosmetic from the social. If there is bullying, the bullying is tackled as well, not instead.
- Put a date on the consultation, not on the operation. Going for an assessment commits you to nothing.
- Have them there and ask them directly. It is the best filter there is.
What to ask in clinic
- Which predominates in their case: the fold, the concha or the lobe?
- Which technique do you propose, and does it use sutures or cut cartilage?
- Which anaesthetic is appropriate for their age?
- How long off school, and when can they go back to sport?
- What happens if the result is not what we expected, and who covers a revision?
- How likely is it that the ears will spring out again?
Book an appointment
You can book your own appointment. Pick the day and time from the free slots in the diary, in a panel that opens right here, without leaving this page.
Frequently asked questions
At what age can a child have ear surgery?
The usual reference is from the age of 5 or 6, because by then the ear has reached 80-90% of its adult size and later growth does not compromise the result. SECPRE puts the threshold at 6 years, conditional on the child wanting it.
My child does not want surgery, should we talk them into it?
No. SECPRE itself makes the indication conditional on the child stating that they want the appearance of their ears changed, and that is our criterion too. When the motivation belongs only to the parents, the sensible thing is to wait: there is no urgency at all and the margin is years.
Is it worth it? Does it really help?
The evidence says yes when the request comes from the child. In a Spanish series of 55 children, quality of life clearly improved and 96% of parents would recommend it, and reviews of the subject describe a significant and lasting improvement. What surgery does not do by itself is resolve bullying.
Is it painful? What anaesthetic do they have?
It depends on age: in children, general anaesthesia is usually used, and in teenagers and adults local anaesthesia with sedation can be considered. It is one of the questions worth asking in clinic, because it also affects the price.
How long off school?
Children usually go back to school at around a week. Our headband protocol is specific: twenty-four hours a day for the first five days and nine more days only for sleeping and while at home. That means they do not wear it to school. During that time, activities that could pull on or strike the ear are avoided.
Can the ears spring out again?
It is the most frequent issue with this operation: the systematic review puts reoperation or recurrence at around 5%. That is low, but it is not zero, and it is worth knowing beforehand.
And if we do not like the result?
That is the question to ask before surgery. It is worth knowing which technique is used — the risk of an irreversible result is higher with those that cut or score cartilage than with suture techniques — and what the clinic’s policy is on revisions and complications.
Sources
- Carvalho C, Marinho AS, Barbosa-Sequeira J, Correia MR, Banquart-Leitão J, Carvalho F. Quality of life after otoplasty for prominent ears in children. Acta Otorrinolaringol Esp (Engl Ed). 2023;74(4):226-231. PMID 36427795 — 55 children with a median age of 7.7 years, assessed with the paediatric quality of life inventory and an adaptation of the Glasgow Children Benefit Inventory: a clear improvement in quality of life, previous bullying and high parental expectations as predictors of greater reported benefit, and 96% of parents would recommend the surgery.
- Braun T, Berghaus A. [Otoplasty and quality of life]. HNO. 2015;63(1):28,30-33. PMID 25527381 — several studies using validated tools show a significant and lasting increase in health-related quality of life in children and adults; warns that irreversible deformities after a failed otoplasty can be more emotionally draining than the preoperative situation, with a higher risk in techniques that score or cut cartilage than in suture techniques.
- 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: reoperation or recurrence at around 5%, haematoma or bleeding 2.5%, suture problems 1.8%, healing problems 1.6% and infection 0.8%.
- Pawar SS, Koch CA, Murakami C. Treatment of Prominent Ears and Otoplasty: A Contemporary Review. JAMA Facial Plast Surg. 2015;17(6):449-454. PMID 26158729 — prominent ears affect approximately 5% of the population and can have a significant psychological impact.
- Spanish Society of Plastic, Reconstructive and Aesthetic Surgery (SECPRE). Cirugía de las orejas. secpre.org — age from 6 years onwards, conditional on the child’s wishes.
Sources checked one by one against PubMed on 13 August 2026.
Book your consultation
Going for an assessment does not commit you to surgery. At the Instituto de Cirugía Plástica del Mediterráneo, in Valencia, the consultation is held with the child present and the child is asked directly; and if what comes out of it is that waiting is the better course, that is what we say.
Clinical confirmation by the surgeon
Awaiting signature.
Patient information reviewed by Dr Elena García Vilariño, registration no. 46/4624503, and Dr Enrique Salmerón González, registration no. 46/4624077, specialists in Plastic, Aesthetic and Reconstructive Surgery. Deciding on surgery in a minor requires a face-to-face assessment with the child and their parents; this information does not replace a medical consultation.
Registration no. 46/4624077
Registration no. 46/4624503
Last reviewed: 6 September 2026. This content is for information only and does not replace an individual assessment by a healthcare professional.
