Otoplasty in Valencia | Prominent Ear Surgery

In short

It acts on the cartilage of the outer ear, not on the ear itself: it does not touch the ear canal or the middle ear, and therefore does not affect hearing.
In children it can be considered from the age of 5 or 6, once the ear has reached around 80-90% of its adult size — and only if the child wants the surgery, not just their parents.
The anaesthetic depends on age: general in young children, who will not cooperate with a local; local with or without sedation in older teenagers and adults.
In a systematic review of 28 studies and 3,493 patients, the commonest complication was reoperation or recurrence, at around 5%; haematoma 2.5%, suture problems 1.8% and infection 0.8%.
In the Comunitat Valenciana, public hospitals have been treating it in under-16s, although the national rules exclude, in general terms, anything aesthetic “not related to an accident, an illness or a congenital malformation”.
Guide price: between 2,400 and 3,900 €, depending on the technique, the anaesthetic and whether one ear or both are operated on. Always subject to prior assessment.

Otoplasty is surgery whose purpose is to correct the shape, the size or the position of the outer ear. It is one of the most requested operations in facial plastic surgery, because it gives natural results without affecting any other function of the ear and the recovery is short. It is mainly indicated for prominent ears, although it is also used for asymmetry, congenital malformations and the after-effects of injury.

At the Instituto de Cirugía Plástica del Mediterráneo, in Valencia, we carry out this surgery with an approach tailored to each patient, seeking a balanced improvement to the face.

What otoplasty is

Otoplasty is a surgical technique that acts directly on the ear cartilage in order to reshape the structure of the ear. It can bring the ears closer to the head, reduce their size, correct abnormal shapes or restore lost symmetry.

One very common worry, particularly among parents, is worth clearing up straight away: the surgery acts on the outer ear — cartilage and skin — not on the ear canal or the middle ear. Otoplasty does not change hearing.

Although it is regarded as cosmetic surgery, its effect goes beyond appearance: many people who have lived with prominent ears since childhood describe discomfort or self-consciousness that affects their emotional well-being and their social life.

The main aims of otoplasty

The aims of otoplasty can be summed up as follows:

Correcting ears that project too far (prominent ears)
Restoring the natural folds of the ear, such as the antihelix
Reducing the size of the outer ear where it is out of proportion
Correcting asymmetry between the two ears
Repairing congenital malformations
Treating deformities acquired after accidents or previous surgery
Improving facial proportions and the aesthetic balance of the face

Every operation is personalised. The assessment beforehand determines which techniques are used and what results can be achieved, always with realistic expectations and on medical grounds.

When is this surgery indicated?

Otoplasty is indicated for people with one or more of the following:

Prominent ears: ears that stand out markedly from the skull
Cartilage folds that are poorly formed or missing
An outer ear that is out of proportion in size
Noticeable asymmetry between one ear and the other
Deformity caused by injury or by previous surgery
An ear that has not developed fully

There is also secondary otoplasty, indicated where previous surgery has left an insufficient result, an over-correction or a recurrence over time. It is technically more demanding and requires waiting until the tissues have settled.

At what age can surgery be done?

There is no upper age limit: adult cartilage is operated on in the same way, it is simply a little stiffer.

In children the usual reference point is from the age of 5 or 6. The reason is anatomical: by that age the outer ear has reached around 80-90% of its adult size, so the correction is not undone by later growth. SECPRE, the Spanish society of plastic, reconstructive and aesthetic surgeons, puts the age from which it can be considered in children at 6.

There is a condition we consider as important as the anatomical one, and which SECPRE itself sets out: the child must say that they want the appearance of their ears changed. A child who does not want surgery is not operated on. Where the wish comes only from the parents, the sensible course is to wait.

For minors, the decision rests with those holding parental responsibility, taking the child’s view into account according to their maturity. In our practice we always involve both parents and the child in the assessment.

The anatomy involved: cartilage and the outer ear

Our team has published on this surgery: in 2018 we compared two cartilage-sparing techniques across 356 otoplasties performed in children, in Annals of Pediatric Surgery. Much of the judgement on this page rests on that series.

Otoplasty acts mainly on the ear cartilage, the elastic structure that gives the ear its shape. Through minimal incisions the surgeon moulds this cartilage to change its curve, reduce its volume or alter its orientation. The skin of the ear may also be worked on, with a small amount removed where necessary.

Precise anatomical knowledge of this region is essential to a natural, lasting result. Handling the cartilage badly can create artificial folds or secondary deformity.

All three causes can coexist in the same ear. Which of them predominates is what decides the technique: folding the antihelix, reducing or repositioning the concha, or both. That is why the assessment beforehand is not a formality.

An ear does not stand out “just because”. Behind it lie an inner fold that never formed, a central hollow that is too deep and pushes it out, and an angle between ear and head that is wider than usual. The first two are shown here, because they are the ones that change the shape; the angle is assessed from above. Knowing which one is in charge is what decides what has to be done, because they are not corrected in the same place or with the same manoeuvre.

The consultation beforehand: what is assessed

An individual assessment before surgery is essential. The consultation looks at:

The shape, size and projection of the outer ear, and which of the three usual causes predominates
The elasticity and thickness of the cartilage, which shape the technique
The symmetry between the two sides and the balance with the rest of the face
Medical history, and in particular any tendency to heal badly or to form keloids, because the area behind the ear is a high-risk site
The patient’s expectations, which have to be achievable

That assessment produces the technique proposed, the type of anaesthetic and an explanation of the process, the risks and the timescales. Nothing read on a website replaces that consultation.

This is an important difference from what is usually written. There is no figure beyond which an ear becomes “wrong”: what is assessed is the whole, and above all whether it is weighing on the person who has them.

How is an otoplasty done?

The procedure is a day case and takes about 90 minutes. The usual steps are:

Pre-operative marking of the surgical design
A discreet incision behind the ear
Exposing the cartilage and reshaping it with internal sutures
Correcting folds or excess cartilage
Adjusting the position of the ear in relation to the skull
Closing the incision with very fine sutures

The anaesthetic depends on age. In older teenagers and adults a local anaesthetic is used, with or without sedation. In young children a general anaesthetic is used, simply because it is not realistic to ask them to cooperate for an hour and a half under local. It is a day-case procedure: the patient goes home the same day, wearing an ear band that protects the area and holds the new shape. A dressing is not usually applied; it is kept for particular cases. The band is supplied by the patient and brought to theatre on the day of surgery.

Recovery, day by day

The timescales below are a guide and are adjusted at each review.

The first few days. The ear band is worn around the clock. There may be swelling, bruising and discomfort, controllable with the painkillers prescribed. Pain and itching are common: the literature describes them in around 13% of patients.

The first week. Adults usually go back to work at around five days, and children return to school at about a week. It is best to avoid sleeping on the operated side.

The band, until day 14. Our schedule is specific: the band is worn around the clock for the first five days and then for nine days more, only for sleeping and while at home. That is, from day 6 you can go out, go to work or go to school without it. Activities that could pull on or knock the ear are restricted, sleeping on the operated side is avoided, and the return to sport is gradual, with contact sports the last to resume.

From the first month onwards. The shape is visible from the start, but the result is considered final once the tissue has finished healing and the swelling has gone down completely, at around six months.

The shape is visible from the very first moment, but the result is not judged until the swelling has gone down completely. Contact sports are the last thing to resume.

What results can you expect?

The aim is an ear in proportion, with a natural curve and in harmony with the face. The scars sit behind the ear, which makes them barely visible in normal view.

Two things are worth saying plainly:

The ears do not end up identical. Nobody has them exactly alike before surgery, and nobody does afterwards either. The aim is harmony, not symmetry to the millimetre.
The correction is stable in principle, but it is not guaranteed for life. A small proportion of cases have a partial recurrence — an ear that stands out somewhat again. It is the commonest complication of this surgery and what to do about it is assessed case by case.

Risks and complications

Like any operation, otoplasty carries risks. The largest systematic review published to date, which brought together 28 studies and 3,493 patients, describes these frequencies:

Reoperation or recurrence: around 5% — the commonest
Haematoma or bleeding: 2.5%
Suture-related problems: 1.8% (the internal sutures can be felt or work their way out)
Healing problems: 1.6%
Infection: 0.8%

To these can be added residual asymmetry, temporary changes in sensation and, in people predisposed to them, hypertrophic scars or keloids. Perichondritis or chondritis — infection of the cartilage — is uncommon but is the complication of greatest concern, because of its potential to deform the ear; that is why it is watched for.

When to ring the clinic rather than wait for your appointment: pain that increases instead of easing, redness and swelling that appear or worsen from the second or third day onwards, fever or discharge. That late pattern points more to an infection of the cartilage than to a haematoma, and it should be seen quickly.

These figures come from the published literature and describe the technique as a whole, not an individual prognosis. Each person’s risk depends on their anatomy, their history and the way they heal, and it is assessed in consultation.

The benefits of otoplasty

It improves facial harmony without altering the expression of the face
It corrects a visible feature often carried since childhood
The scars sit on the back of the ear and are barely visible
It is day surgery, with a short recovery
It does not change hearing

Many patients also describe feeling more comfortable with how they look. That is an effect frequently reported, not a result that can be guaranteed.

Closing thoughts

Otoplasty has a high satisfaction rate and a low complication profile when it is carried out to rigorous medical standards. It is not simply a matter of “pinning” the ears to the head, but of reshaping a delicate anatomical structure that has to sit well with the face.

If you are considering this surgery, for yourself or for your child, the next step is an assessment consultation where the specific case is examined and your questions are answered with no obligation.

Guide price

At the Instituto de Cirugía Plástica del Mediterráneo, an otoplasty comes to between 2,400 and 3,900 € as a guide, depending on the technique, the anaesthetic and whether one ear or both are operated on. The page on the price of an otoplasty in Valencia explains what the quote includes, what drives the range and what happens if a touch-up is needed.

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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.

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Frequently asked questions

Does the Spanish public health service cover ear surgery?

It depends on age and on where you ask. The national rules — Royal Decree 1030/2006, which sets out the common package of services of the Spanish National Health System — exclude in general terms “all diagnostic and therapeutic procedures with an aesthetic purpose that are not related to an accident, an illness or a congenital malformation”; that text mentions no age at all.

In practice, public hospitals in the Comunitat Valenciana have been treating otoplasty in under-16s. In adults, correcting prominent ears on its own is regarded as cosmetic and falls outside cover.

It is best taken for what it is: a clinical policy, not a guaranteed entitlement. Who assesses it, with what reports and with what waiting list depends on each hospital, and the route to raise it is through your paediatrician or GP.

Does ear surgery hurt?

Beyond the injection of the anaesthetic, the operation is not painful. Afterwards, discomfort and itching are common and are controlled with the painkillers prescribed. How pain is felt varies a good deal between people.

Can I have just one ear operated on?

Yes. A unilateral otoplasty is indicated where only one ear is affected. In that case the relationship with the other side is studied with particular care, since it is the reference for the result.

When can I go back to sport?

As a guide, gentle activity resumes in the first few weeks and contact sports are the last, well into the first month or later. The exact timing depends on the sport and on each patient’s progress, and the surgeon sets it at the follow-up appointments.

Does otoplasty affect the ear or hearing?

No. The surgery is carried out on the cartilage and the skin of the outer ear. Neither the ear canal nor the middle ear is operated on.

Does the result last for ever?

The correction is stable in principle. There is, however, a possibility of partial recurrence — around 5% reoperations in the literature — which is assessed individually if it occurs.

Book your consultation

If you want to explore an otoplasty, for yourself or for your child, you can book a consultation with our team in Valencia. At that visit the case is examined, the options and their limits are explained, and your questions are answered before any decision is taken. For children, the assessment is done with the child present and with both parents.

Sources

Sadhra SS, Motahariasl S, Hardwicke JT. Complications after prominent ear correction: A systematic review of the literature. Journal of Plastic, Reconstructive & Aesthetic Surgery, 2017. PMID 28602268. — Systematic review of 28 studies and 3,493 patients; the source of the complication rates quoted here.
Salmerón-González E, García-Vilariño E, Gutiérrez-Ontalvilla P, Miró-Rubio I, López-Blanco EM. Evaluation and comparison of two different cartilage-sparing techniques in 356 otoplasties performed in children. Ann Pediatr Surg. 2018;14(3):143-145. DOI 10.1097/01.xps.0000535042.94193.2. — The ICPM team’s own study: a comparison of two cartilage-sparing techniques across 356 otoplasties in children.
Otoplasty. StatPearls, NCBI Bookshelf. NBK538320. — Ear size at 5-6 years (80-90% of adult), choice of anaesthetic by age, and telling a haematoma from perichondritis by when it appears.
Sociedad Española de Cirugía Plástica, Reparadora y Estética (SECPRE). Ear surgery (in Spanish). secpre.org/cirugia-de-las-orejas. — Age from 6 years in children, conditional on the child themselves wanting it, anaesthetic by age, and return times (≈5 days to work, ≈7 days to school).
Real Decreto 1030/2006, of 15 September, establishing the common package of services of the Spanish National Health System (in Spanish). Annex III, point 5. BOE BOE-A-2006-16212. — Exclusion of procedures with an aesthetic purpose “not related to an accident, an illness or a congenital malformation”.

Clinical confirmation by the surgeon

Content reviewed and validated on 3 August 2026: operating age (5-6 years), choice of anaesthetic by age, recovery timescales, complication rates, warning signs, guide price and policy on revisions.

Dr Elena García Vilariño, specialist in Plastic, Aesthetic and Reconstructive Surgery, registration no. 46/4624503. Dr Enrique Salmerón González, specialist in Plastic, Aesthetic and Reconstructive Surgery, registration no. 46/4624077.