Otoplasty in teenagers: when he (or she) is the one asking

Unlike a seven-year-old, a teenager usually arrives at the consultation having already decided. They bring the request ready, they know how long it has bothered them and they have often looked into it themselves. That changes the whole conversation, and clinically it works in their favour.

What has to be sorted out in that case is not the surgical indication — it is the same at any age — but three practical things: who decides and who signs, which anaesthetic applies and how it fits into the school year.

If you are the one considering this as a parent and your child is younger, the guide is how to decide about operating on a child.

Who decides and who signs

It is the most searched-for question at this age, and it deserves a precise answer without lecturing anyone on the law.

The general framework in Spain is Law 41/2002, on patient autonomy. In practical terms: under 16, consent is given by those holding parental responsibility, always listening to the minor’s opinion according to their maturity; from 16 onwards the law recognises the minor’s capacity to consent for themselves in most medical procedures, with qualifications where the procedure carries serious risk, in which case parents are informed and their opinion taken into account.

Our practice goes a step beyond what the rules require: in patients under 18 we always involve the parents. They are informed, given the explanation and included. It is not bureaucratic caution: cosmetic surgery in a minor is a family decision, and so is the recovery.

And there is one condition that does not depend on any signature: if the teenager does not want surgery, there is no surgery. If the person with a problem about the ears is the family and not them, the answer is to wait.

If the parents are separated, the decision about non-urgent surgery rests with both holders of parental responsibility. Where there is disagreement, the clinic does not arbitrate: the assessment is carried out and the family resolves the disagreement on its own. We do not give legal guidance.

What improves, and how much of it is measured

This is the part usually told with adjectives, and it has figures behind it. Otoplasty is one of the best-studied cosmetic operations in terms of quality of life, and the results all point the same way.

• In children and teenagers, with validated tools. A study of 55 minors assessed with the paediatric quality of life inventory and an adaptation of the Glasgow Children Benefit Inventory found a clear improvement in quality of life, with previous bullying among the predictors of greater reported benefit, and 96% of parents would recommend the surgery.
• Significantly and lastingly. A review of the subject concludes that several studies using validated instruments show a significant and lasting increase in health-related quality of life, in both children and adults.
• Almost everyone reports improvement. In a quality of life series with a mean age of 18.9 years, 41 of 42 patients reported a positive change.
• 🔑 And motivation of one’s own predicts how much difference it makes. In that same study, those who had surgery because of their own distress scored on average 13.8 points higher on the benefit scale than those operated on at the suggestion of their parents or those around them. A teenager who arrives asking for it themselves meets that condition almost by definition.

Even so, it is worth being precise about what improves, because that too has been measured. In adult patients assessed at six months, the body image scale, the visual analogue scale of distress and the appearance-related social anxiety scale all fell significantly; overall self-esteem, measured on its own scale, did not change significantly.

That distinction does not detract: it clarifies. What the evidence supports is that a specific concern stops weighing — how you see yourself and how much it constrains you in front of others — and that is exactly what brings a teenager to the consultation. What no surgery can promise is to rewrite someone’s relationship with themselves.

And all of this describes what was measured in groups of patients, not an individual prognosis: a firm request does not mean the expectation is realistic, and part of the consultation consists precisely in reviewing that.

Bullying, handled carefully

Many teenagers arrive saying they have had comments made about them. It is worth addressing directly and without turning it into a sales argument.

An otoplasty is not the answer to bullying and nobody should present it as a way of avoiding it. Bullying is tackled by other means, and making that depend on the appearance of the person suffering it puts the responsibility on the wrong side.

What is legitimate is something else: that someone is bothered by their own ear, with or without comments, and wants to change it. That is the indication, and it stands on its own.

Which anaesthetic is used at this age

From adolescence onwards, local anaesthetic with sedation is the usual choice, just as in an adult. The reason that makes a general anaesthetic necessary in young children no longer applies, and that reason is not pain but the impossibility of lying still for an hour and a half.

That said, it is an individual decision: it depends on maturity, on how they are taking the idea and on what is going to be done. There are teenagers for whom the idea of being awake is distressing, and that is taken into account. It is discussed in clinic, with them present, because it is their body and their time in theatre.

The day of the operation, with the detail of what it feels like, is set out in an otoplasty step by step.

How to fit it into the school year

The logistics are straightforward because the cycle is short:

• The headband is worn 24 hours a day for the first five days and then for nine more days only for sleeping and while at home. It comes off at around day 14.
• Back to class at around a week, and by then without the headband: they do not wear it to school.
• Gentle PE from a month; contact sports between six weeks and three months.

The three windows that work best are summer, Christmas and Easter. Christmas is usually the cleanest, because two weeks of holiday cover the whole cycle.

On having surgery the summer before an important year — final exams, the first year of university, a change of school: it is as valid a reason as any other, and in fact it is a convenient moment. The only thing worth avoiding is rushing: the assessment is booked months in advance, and surgery should not be competing for diary space with an exam.

Frequently asked questions

I am 15 and I want ear surgery, can I have it?

It can be considered, but at that age consent rests with those holding parental responsibility, having listened to your view. In practice that means you have to discuss it at home and come to the assessment with them.

At 16, can I sign myself or do I need my parents?

Law 41/2002 recognises capacity from 16 to consent for oneself in most medical procedures, with qualifications for procedures carrying serious risk. That said, our practice is always to involve the parents in patients under 18: they are informed and included.

My parents do not want it and I do. What happens?

That it is worth talking about, and that the consultation is a good place to do so, because many of their reservations are resolved with information. What we will not do is operate behind the back of a family that does not agree.

And the other way round: my parents want it and I am not sure.

Then there is no surgery. It is the rule and it has no exceptions: if the person with a problem about the ears is not you, waiting is the right thing to do.

Will I have a local or a general anaesthetic at my age?

From adolescence onwards the usual choice is local anaesthetic with sedation, just as in an adult. It is decided in clinic, with you present, according to maturity and how you are taking the idea.

How much school would I miss?

Around a week. When you go back you will no longer be wearing the headband: from the sixth day it is used only for sleeping and at home.

Will it show when I go back to school?

With your hair down, not much. You go without the headband and with instructions to avoid knocks. What may show in the first few weeks is some swelling, and that the ear is closer to the head than it will end up.

Is it a good idea to have surgery the summer before final exams or starting university?

It is a convenient moment, because there is margin and no school is missed. The only recommendation is to book the assessment months in advance and not to squeeze the surgery in at the last minute.

People at school make comments about my ears. Will surgery solve it?

Surgery can change how you see yourself, and that is a legitimate reason. But bullying is not solved by changing the appearance of the person suffering it, and we are not going to present it that way. If what you are going through is bullying, that has to be addressed on its own terms too, with the school and with your family.

Is the result different at this age?

No. From the age of five or six the ear has already reached around 80-90% of its adult size, so the correction possible is the same. What changes over the years is the stiffness of the cartilage, which shapes the technique and not the result.

Sources

• Law 41/2002, of 14 November, on patient autonomy and on rights and obligations regarding clinical information and documentation. BOE-A-2002-22188. Consolidated text in the BOE — Framework for informed consent in minors: consent by representation of those holding parental responsibility, listening to the minor’s opinion according to maturity, and the regime from 16 onwards.
• Baek SR, Courtemanche R, Boroditsky M, Arneja J. Quality of Life After Mustardé Otoplasty for Prominent Ears. Plast Surg (Oakv). 2026. PMID 42064164 — Mean age 18.9 years; 41 of 42 patients reported a positive change in quality of life, and those who had surgery because of their own distress scored on average 13.8 points higher than those for whom the indication came from parents or from those around them. It is the source of the section on motivation of one’s own.
• 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: a clear improvement in quality of life and in previous bullying, with 96% of parents recommending 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 after an otoplasty.
• Aliyeva A, Yagız O, Ceylan ME. Otoplasty in Adults: Psychological Impacts on Quality of Life. Indian J Otolaryngol Head Neck Surg. 2024;76(2):1481-1490. PMID 38566726 — At six months, body image, visual analogue scale and appearance-related social anxiety scores fell significantly, while overall self-esteem did not change significantly.
• Spanish Society of Plastic, Reconstructive and Aesthetic Surgery (SECPRE). Cirugía de las orejas. secpre.org — Anaesthetic by age, the age from which it can be considered in minors and approximate times before returning to normal activity.
• Otoplasty. StatPearls, NCBI Bookshelf. NBK538320 — Size of the ear from 5-6 years onwards, at around 80-90% of the adult size, and choice of anaesthetic by age.

Book your consultation

If you are the one looking this up, the first thing is to talk about it at home: under 18 the assessment is done with your parents, and it usually resolves more of their questions than yours.

At the consultation we examine your ear, explain what can and cannot be achieved, and decide with you there which anaesthetic applies and when it best fits your school year. And if what comes out of that conversation is that it is not yet the moment, we will tell you that too.

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