Otoplasty results: what to really expect and whether the ears can stick out again

Yes, the ears do move out a little after surgery, and that is normal. In the first few weeks they sit closer to the head than they will end up, and as the swelling goes down and the cartilage settles they recover a little projection. That small, early movement is the expected settling, not a failure.

A recurrence is a different matter: the ear returning towards its original position. It happens in a minority of cases — published reviews put it between 2.8% and around 5% — and it is still the most frequent complication of this operation. Telling the two apart is what prevents half the frights of the first year.

The overall complication figures and the full procedure are set out in the otoplasty guide. This page is only about the result and how long it lasts.

Settling is not recurrence

This is the confusion that causes the most anxiety, and it is understandable: someone has surgery, sees the result at a week, and a month later feels the ears are “opening up again”.

Here is what is really happening. Immediately after surgery the ear is swollen and under the maximum tension of the internal sutures that have just folded the cartilage. In that snapshot the ear is closer to the head than it will ever be again. As the swelling settles and the cartilage accommodates to its new shape, it recovers a little projection. It is a small movement, it happens in the first few weeks, and then it stops.

A true recurrence behaves differently: it is a return towards the starting position, it is larger, and it appears later — months or even years afterwards. What has failed there is not swelling going down: it is cartilage overcoming its fixation.

The practical consequence is that the result is not judged in the first month. Neither for better nor for worse.

What the figures say

There are two references worth giving together, because they measure different things and giving only one would mean choosing the convenient one.

• A 2026 meta-analysis pooling 18 studies, 1,590 patients and 3,060 ears, with a mean follow-up of 24.5 months, describes a combined recurrence rate of 2.8% and a reoperation rate of 2.1%. In that same review the most frequent complication is not recurrence but suture extrusion, at 5.4%: an internal stitch that works its way out or becomes palpable, and that is dealt with in clinic.
• The largest systematic review published, with 28 studies and 3,493 patients, puts reoperation or recurrence at around 5%, and there it is the most frequent complication in the series.

Both are good sources, and the difference between 2.8% and 5% is not an error: they pool different studies, with different techniques and different follow-up. What both agree on is that the ear springing back is the characteristic problem of this operation, and that it happens in a minority of patients.

These figures describe published practice as a whole, not your prognosis. Each person’s risk depends on their cartilage, on how they heal and on the technique used, and it is discussed in clinic.

The technique affects how long it holds

A 2026 systematic review of surgical techniques for the prominent ear points to combined approaches — suturing together with controlled weakening of the cartilage — being associated with fewer recurrences and fewer reoperations than those relying on a single manoeuvre.

It makes mechanical sense: if the cartilage is only folded with stitches, all the tension falls on those stitches and the cartilage keeps pushing; if it is also weakened in a controlled way exactly where you want it to give, the new fold holds with less help.

This does not make one technique the good one and the rest bad, and that is not what we are going to claim: the choice depends on the cartilage in front of you, and different manoeuvres can be combined on the same ear. What it does explain is why the cartilage is examined and palpated in clinic before anything is decided, and why the answer to “which technique will you use on me?” cannot be given over the phone.

Symmetry: nobody has two identical ears

Neither before nor after. If you look at yourself now, one of your ears sits slightly further out, or slightly higher, or has a slightly different fold from the other. That is normal on any face.

Surgery aims for harmony, not millimetre symmetry. What makes the ear stand out is corrected and the small difference is respected — among other reasons because chasing exact symmetry usually makes the result worse: it forces you to overdo one side.

In practice this means that a difference of a few millimetres between the two ears after surgery is not a complication. An obvious asymmetry, one you can see from the front at normal distance, is something we do assess.

The result we avoid: the “pinned-back” ear

It deserves a section because it is the mirror image of the fear of recurrence, and because it is harder to put right.

An ear that is too tight against the skull looks artificial. The benchmark for a good result is not that the ear disappears in profile: it is that, looking from the front, the outer rim of the ear remains visible outside the inner fold, with its curve intact. When that relationship is lost, the ear gives the surgery away even though it is “nicely pinned back”.

There are two classic ways of getting this wrong: over-folding the upper part and leaving it at too closed an angle, and correcting the top without following through at the bottom, which leaves the upper half pinned and the lobe sticking out. These results are prevented by assessing the whole ear, lobe included, and not just the part that bothers the patient most.

That said, within what counts as a natural result there is room for choice, and that is where we adapt to each person’s preference. Some people want the correction to be just enough and others prefer it a little more marked, and both are possible. What is not possible is the extreme: an ear flattened against the skull gives the surgery away, and when someone asks for exactly that, the honest answer is usually no.

So it is worth bringing that preference to the consultation and discussing it on your own ear, which is where the real margin becomes visible.

When the definitive result is visible

The new shape is visible from day one, but it goes through stages:

• First week. Very tight against the head and still swollen. This is not the result.
• First month. The swelling goes down and the ear recovers some projection. This is the stage where most people take fright.
• Three months. The shape is practically definitive and the scar is still maturing.
• Six months. The tissue has finished healing and this is the moment to judge the result.

On satisfaction, the published series are consistent: in a 2026 study using objective measurements of the ear, 75% of patients described themselves as very satisfied and 22% as satisfied — 97% positive ratings — with satisfaction showing no correlation with age or sex. It is a figure to read with a cool head: it describes study cohorts, not a guarantee.

And if it genuinely springs out, what then?

First, look at it and confirm that it is recurrence and not settling. Second, wait for the tissue to be mature: an ear that has just been operated on is not reoperated unless there is a specific reason.

Secondary correction is technically more demanding than a first operation, because there is scar tissue, the cartilage may already have been modified and the planes do not separate in the same way. It is planned with a specific assessment and with adjusted expectations.

As for who bears the cost of that revision, it is a conversation worth having before surgery rather than afterwards. Our policy on complications and revisions is written out in the general guide, and it forms part of what is explained in clinic.

Frequently asked questions

Is the result of an otoplasty permanent?

It is stable in the great majority of cases, but it cannot be guaranteed for life. Published reviews describe recurrence or reoperation of between 2.8% and around 5%. Anyone promising permanence is promising something the literature does not support.

Is it true that the ears “move out a little” after the operation?

Yes, and it is to be expected. Straight after surgery the ear is swollen and the stitches are under maximum tension, so it sits closer to the head than it will end up. As the swelling goes down it recovers some projection. It happens over the first few weeks and then stops.

And how do I tell that apart from a real recurrence?

By size and by timing. Settling is small and early; recurrence is a clear return towards the original position and usually appears later, months or years afterwards. If in doubt, we look at it in clinic: it is a two-minute examination.

Will my ears end up too flat or looking artificial?

That is a result we actively work to avoid, because an ear that is too flat gives the surgery away. The benchmark is that, from the front, the outer rim should remain visible outside the inner fold. Within that margin we adapt to what you prefer: some people want the correction to be just enough and others prefer it a little more marked. If the expectation is that the ears should disappear in profile, it is worth discussing that in clinic before operating.

Will both ears end up exactly the same?

No, and they are not the same now either: nobody has two identical ears. The aim is harmony, not millimetre symmetry. Small differences are normal; an obvious asymmetry is something we do assess.

When is the final result visible?

At around six months, once the swelling has fully gone and the tissue has finished healing. By three months the shape is already practically final.

Is the result as good in adults as in children?

The aim and the result you can expect are the same. What changes is the technical route, because adult cartilage is stiffer. In the published series, satisfaction does not correlate with age.

Does the technique used change the chances of it coming back?

The available evidence suggests that combined approaches — suturing plus controlled weakening of the cartilage — are associated with fewer recurrences than those relying on a single manoeuvre. That said, the technique is chosen according to the cartilage of each ear, not from a catalogue.

If it springs out again, can it be operated on a second time?

Yes, with a specific assessment. We wait for the tissue to be mature and plan it as secondary surgery, technically more demanding than the first. Expectations are set in that consultation.

Can I see before-and-after photographs of real cases?

Cases are shown in clinic where there is express consent to do so. We do not publish images of minors, and those we do show always correspond to adults who have specifically authorised their use.

Sources

• 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, 1,590 patients and 3,060 ears, mean follow-up 24.5 months: combined recurrence 2.8%, reoperation 2.1% and suture extrusion 5.4% as the most frequent complication.
• 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%, the most frequent complication in the series.
• Thomson H, Gosden J, Mandal A. Otoplasty for prominent ear: A systematic review of surgical techniques. JPRAS Open. 2026;49(4):221-233. PMID 41858427 — Hybrid approaches combining suturing with cartilage weakening are associated with lower recurrence and reoperation rates than single-technique approaches. Supports the section on technique.
• Madaras T, Bărăbancia-Romete M, Bodog R, et al. Objective Auricular Measurements and Patient Satisfaction Following Cartilage-Cutting Otoplasty Using Fascioperichondrial Flaps. J Clin Med. 2026;15(10):3795. PMID 42194756 — Patients aged 6 to 37: 75% very satisfied and 22% satisfied, with no correlation between satisfaction and age or sex. Source of the satisfaction figures.
• Grella R, Molle M, Crisci E, et al. Modified Anterior Scoring Otoplasty Without Sutures: Description and Case Series. Aesthetic Plast Surg. 2025;49(11):2949-2955. PMID 40164896 — Series of 50 patients with no recurrences during follow-up and abnormal scarring in 16% of cases; illustrates both that cartilage weakening holds the shape and that it is not free of cost.
• Spanish Society of Plastic, Reconstructive and Aesthetic Surgery (SECPRE). Cirugía de las orejas. secpre.org — General framing of the procedure and of recovery times.

Book your consultation

If what is holding you back is the fear that it will not look natural, or that it will spring out again, that is not resolved by reading: it is resolved by looking at your ear. At the assessment we examine the cartilage, explain what can and cannot be achieved in your particular case, and tell you what margin of stability we are working with.

You will also be told if we believe your expectation is not achievable. That is a conversation better had before than after.

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