Revision otoplasty: when the result is not what you expected

Sometimes an otoplasty does not end where it was meant to: the ear recovers part of its projection, the two sides do not match, or the result looks too forced. It can be corrected, and that is called a revision otoplasty.

That said, there are two things worth knowing before booking an appointment. The first is that many “results that do not convince” are results that are still settling, and at a few weeks nothing is judged. The second is that a reoperation is technically more demanding than the first and has real limits, which are explained beforehand and not afterwards.

What is normal as the months pass is covered on the results page. This page deals with what is no longer settling.

First: is it the result, or is it still settling?

This is the question to answer before any other, because whether there is anything to decide depends on it.

After an otoplasty the ear sits closer to the head than it will end up, because it is swollen and the sutures are under maximum tension. As the swelling goes down it recovers some projection: it is a small movement, it happens in the first few weeks and then it stops. It is not a failure, it is normal settling.

The result is considered definitive at around six months, once the tissue has finished healing. Before that date, what you see is still moving.

There is one exception: what is looked at without waiting are the signs of a complication — pain that increases, redness appearing after the first few days, fever, discharge — and stitches working their way out through the skin, which are the most frequent complication of this operation and are dealt with in clinic.

What a revision corrects

These are the situations that come to a consultation of this kind:

• Residual projection or recurrence. The ear has sprung back, wholly or partly, towards its starting position. It is the most frequent issue with otoplasty: published reviews put reoperation or recurrence between 2.1% and around 5% depending on the series.
• Asymmetry. A qualification is needed: nobody has two identical ears, before or after, and a difference of a few millimetres is not a complication. What is assessed is asymmetry visible from the front at normal distance.
• Overcorrection. The ear has ended up too tight against the skull and the result looks artificial. The benchmark for a natural ear is that, looking from the front, the outer rim remains visible outside the inner fold.
• Imbalance between the middle of the ear and its poles. When the middle is well corrected but the extremes — the top, or the lobe — stand away, the whole looks odd even though each part is “fine”. It is one of the reasons for assessing the whole ear, lobe included, and not just the part that bothers you most.
• Stitches that are palpable or work their way out. They are dealt with in clinic and do not require a full reoperation.
• Scar problems, which have a route of their own and are covered on the page about the scar and keloids.

Why you have to wait

Because the tissue has to mature. Reoperating on an area still swollen and with the scar still forming gives worse results and makes it harder to judge exactly what needs correcting.

Our reference interval is from six months onwards, although it may vary according to the case and the surgeon’s technical judgement. It coincides with the point at which the result stops moving, so it is the first date at which it makes sense both to judge the result and to consider correcting it. Waiting is not stalling: it is the condition for the second operation to make sense.

In the meantime things are done: follow-up, scar care and resolving what can be resolved sooner, such as a stitch working its way out.

Why it is more demanding than the first

Three reasons, and all three are felt in theatre:

• There is scar tissue. The planes do not separate as in an unoperated ear, and that makes the work slower and less predictable.
• The cartilage may already have been modified. If cartilage was removed or weakened at the first operation, you are starting from a different material.
• There is less margin. In a first operation you can plan on a complete anatomy; in a revision you work with what was left.

That is why a revision otoplasty is assessed in more detail before anything is proposed, and also why it costs more than a first operation, something reflected on the price page.

What cannot be promised

This is where it is worth being particularly clear, because it is where most expectation is created.

What has been removed does not come back. If cartilage or skin was excised at the first operation, that tissue is gone. It can be partly reconstructed, but not always and not completely.

There are results that only improve partially. The literature says it uncomfortably but honestly: it has been described that irreversible deformities after a failed otoplasty can be more emotionally draining than the situation before surgery, and that this risk is higher with techniques that score or cut cartilage than with those relying on sutures. That is not an argument against correcting: it is an argument for approaching the correction with adjusted expectations and for explaining the limits clearly from the first consultation.

And a second operation is not a guarantee either. It has its own risks, its own recovery and its own possibility of recurrence.

If you had surgery elsewhere

It is a common reason for coming to see us and it is worth saying how we handle it.

It is in fact a frequent consultation: we regularly see patients operated on at other clinics. Each case is assessed by the surgeon and taken from there.

We do not pass judgement on another surgeon’s work. We do not know what anatomy they found, what technique they chose or why, and offering an opinion on that from outside is neither serious nor helpful to anyone. What we do is look at your ear today and tell you what can be done with it.

Nor do we give legal advice or guidance on claims: it is not our field.

What helps make the consultation useful:

• The operation note, if you have it. Knowing which technique was used changes the planning a great deal.
• Previous photographs, if you have kept any.
• The date of the operation, so we know where we are in the maturing process.

Frequently asked questions

I had surgery two months ago and I think they have sprung out again. Is it a recurrence?

Probably not yet. In the first few weeks the ear recovers some projection as the swelling goes down, and that is normal settling. The result is not judged until six months. If in doubt, we look at it in clinic: it is a two-minute examination.

How long do you have to wait before reoperating?

From six months onwards, although the interval may vary according to the case and the surgeon’s technical judgement. It coincides with the point at which the result stops moving; reoperating earlier gives worse results and makes it harder to judge exactly what needs correcting.

What can be corrected?

Residual projection, visible asymmetries, overcorrection and imbalance between the middle of the ear and its poles. Stitches working their way out are dealt with in clinic, with no need for a full reoperation.

Is it harder than the first operation?

Yes. There is scar tissue, the cartilage may have been modified and there is less room for manoeuvre. It is assessed in more detail and usually requires more specific planning.

Can it be left as though nothing had happened?

Not always. What was removed at the first operation does not come back, and there are situations in which only partial improvement is possible. It is a conversation worth having at the first consultation, not after the second operation.

I had surgery at another clinic. Will you see me?

Yes, and often: patients operated on at other clinics are a routine part of this consultation. Each case is assessed by the surgeon and taken from there. We do not pass judgement on the previous operation or on whoever performed it, and we do not give legal guidance. Bringing the operation note and previous photographs helps a great deal.

I have read about a “badly done otoplasty”. Is that what happened to me?

It is the phrase that circulates on forums and it almost never describes accurately what has happened to anyone. What we see in clinic are results that fell short, ears that recovered projection, asymmetries or corrections that went too far, and many of them do not mean anything was done badly: this operation has a known and published recurrence rate, between 2.1% and around 5%. What is useful is not labelling the previous operation, but knowing what margin is left in your ear today.

Does it cost more than a first otoplasty?

Yes. It is technically more demanding and that is reflected in the quotation, which is fixed after the assessment.

And if only one ear bothers me?

Just one can be operated on, although it is worth knowing that the aim is the balance of the whole: sometimes the best way to match two ears is to work on the one that looked correct. It is assessed in clinic.

I am afraid the second will turn out worse.

It is a reasonable worry and the honest answer is that a second operation has its own risks, including the possibility of recurrence. What reduces that risk is waiting for the tissue to be mature, planning on what is there and adjusting expectations before going into theatre.

Sources

• Braun T, Berghaus A. [Otoplasty and quality of life]. HNO. 2015;63(1):28,30-33. PMID 25527381 — 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. It is the source of the section on limits.
• 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: combined reoperation rate 2.1% and recurrence 2.8%; suture extrusion, at 5.4%, is 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.
• Genç B. A Novel Approach to Upper Pole Correction in Otoplasty: Addressing the Surprisingly Neglected Inferior Crus. Plast Reconstr Surg. 2026. PMID 41825085 — Addresses residual prominence of the upper pole specifically, one of the causes of reoperation, with a revision rate of 3.3% against 8.3% in the historical control.
• Thomson H, Gosden J, Mandal A. Otoplasty for prominent ear: A systematic review of surgical techniques. JPRAS Open. 2026;49:221-233. PMID 41858427 — Systematic review of 22 studies: hybrid approaches are associated with lower rates of recurrence and reoperation than single-technique approaches.

Book your consultation

If more than six months have passed and you are still not happy with the result, it makes sense for someone to look at that ear. At the assessment we examine what was done, what margin is left and what improvement is realistic, with both things said: what can be corrected and what cannot.

And if six months have not yet passed, come anyway. What you may need to hear is that it is still settling.

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.