# Protruding ears: otoplasty and recovery What causes protruding ears, how I perform otoplasty and what to expect at each stage of recovery, from the headband to sports. [Dr. Walter Zamarian Jr.](https://www.walterzamarianjr.com/us/walter-zamarian/) · CRM-PR 17.388 · RQE 15.688 Published February 19, 2026 · Updated October 24, 2026 [Read the article ↓](#leitura) ## At a glance: what are surgery and recovery like for protruding ears? Otoplasty reshapes the ear cartilage through an incision behind the ear. I use the Pitanguy island technique to recreate the fold of the ear; surgery takes about 1 hour 15 minutes under total intravenous anesthesia, and you can go home the same day. The compression headband stays on for three weeks, and the stitches come out at two. - Cause: a flat antihelix, a deep concha or both; sometimes the earlobe. - Technique: the Pitanguy cartilage island; for a deep concha, conchal rotation and sometimes removal of part of the cartilage. - Preparation: lab tests and a surgical risk assessment with an ECG for everyone, children included. - Headband: three weeks, 24 hours a day, off only to shower; then it comes off for good. - Activity: light exercise at one month; everything, including contact sports, at two months. - Risks: hematoma, infection, exposed sutures and the ear partly moving back out. My [otoplasty](https://www.walterzamarianjr.com/us/face/otoplasty/) page covers candidacy, techniques described in the literature, results and risks. Here I explain what causes protruding ears, how I perform the surgery and what to expect at each stage of recovery. ## What causes protruding ears Protruding ears are not a disease and are not associated with hearing loss [1]. They are a variation in the cartilage that makes the ear stand farther from the head. At the consultation, I examine each ear separately, because the cause may differ between sides. ### A flat antihelix The antihelix is the Y-shaped fold just inside the rim of the ear. When it is underdeveloped, the upper part of the ear tilts forward. ### A deep concha The concha is the hollow next to the ear canal. When it is very deep, it pushes the whole ear outward. The earlobe may also stand out, and one ear often protrudes more than the other. Surgery can reduce the difference, but small asymmetries usually remain. ## How I perform the surgery The incision is on the back of the ear, where I also remove the excess skin. To recreate the antihelix, I use the island technique I learned from Professor Ivo Pitanguy: an island of cartilage is cut out and repositioned to form the new fold [2]. It is the only technique I use: I don’t perform the Furnas or Mustardé techniques. When the concha is deep, I rotate the concha and sometimes remove part of the cartilage. Sometimes I deliberately overcorrect slightly, because some of the projection can return in the first few weeks. In my hands, otoplasty takes about 1 hour 15 minutes. I use total intravenous anesthesia (TIVA) for children and adults, as in almost all of my surgeries. You can go home the same day if you wish; because I operate on these cases in the afternoon, discharge is around 10 p.m. Beforehand, everyone has lab tests and a surgical risk assessment with an electrocardiogram (ECG), children included. ## Recovery, stage by stage ### The first few days A padded dressing protects the ears. Pain varies: some people have moderate discomfort, others only mild symptoms. Swelling, bruising and changes in sensation are expected and improve gradually. ### Up to week three The dressing is replaced by the compression headband, which holds the new position while the cartilage heals and protects the ears from rubbing against the pillow. I ask you to wear it for three weeks, 24 hours a day, taking it off only to shower; after that it comes off for good, with no nighttime use. The stitches come out at two weeks. According to the ASPS, most people return to school or work in about a week [3]; many adults go back during the last weeks of headband use. ### From month one to month six At about one month, you can usually sleep on your side, wear glasses and resume light exercise. All activity, including contact sports, is allowed at two months. The shape becomes more defined between the first and third months, and swelling and sensitivity can keep changing for up to about six months. Follow-up visits continue for one year. My [post-surgical recovery](https://www.walterzamarianjr.com/us/post-surgical-recovery/) page covers general aftercare. ## Scar The scar sits behind the ear, in a discreet position, but it is permanent. This area is slightly more prone to keloids: if you or your family have that history, I examine old scars before recommending surgery and, depending on the case, postpone the operation or add preventive care afterward. ## Risks and warning signs Possible complications include hematoma, infection, a widened scar or keloid, sutures showing through the skin, changes in sensation, asymmetry and the ear partly moving back out, which may need revision [4][5]. A meta-analysis of cartilage-sparing techniques estimated recurrence or reoperation at 4.27%, hematoma at 1.34%, exposed sutures at 2.46%, keloid at 0.95% and infection at 0.63% [5]. These figures help put the risk in perspective, but they are not a promise for your case. Pain that increases after the first few days, redness, warmth, discharge or fever may signal an infection, which can damage the cartilage. If that happens, contact the team right away. ## Questions Do I need to wear the headband at night after three weeks? No. I ask you to wear it 24 hours a day for three weeks; after that it comes off for good. Can the ears move back out? To some degree, yes. It depends on the cartilage, the technique, healing and proper use of the headband. No technique eliminates that risk. Can adults have otoplasty? Yes. Adult cartilage tends to be firmer, which affects the planning; the technique is still the Pitanguy one. Does the surgery affect hearing? No. Otoplasty works on the cartilage and skin of the outer ear and does not involve the ear canal. ## Let’s talk about your ears If your ears, or your child’s, are a concern, [write to us on WhatsApp](https://www.walterzamarianjr.com/us/contact/): Bruna, my AI assistant, handles the first contact and then puts you in touch with Isanna to arrange a consultation with me, including from abroad. I examine the cartilage and explain what surgery can and cannot change. For children, my article on [otoplasty timing for children](https://www.walterzamarianjr.com/us/blog/otoplasty-for-children-timing-and-care/) covers the criteria. ## References - American Society of Plastic Surgeons. [Ear Surgery](https://www.plasticsurgery.org/cosmetic-procedures/ear-surgery). - Maricevich P, Pitanguy I, et al. [Island technique for prominent ears: an update of the Ivo Pitanguy clinic experience](https://pubmed.ncbi.nlm.nih.gov/21813875/). Aesthet Surg J. 2011. - American Society of Plastic Surgeons. [Let’s hear it for otoplasty!](https://www.plasticsurgery.org/news/articles/lets-hear-it-for-otoplasty). - American Society of Plastic Surgeons. [Ear Surgery Risks and Safety](https://www.plasticsurgery.org/cosmetic-procedures/ear-surgery/safety). - Alanazi H. [Complications of Cartilage Sparing Otoplasty: A Systematic Review and Meta-Analysis](https://pubmed.ncbi.nlm.nih.gov/38363310/). J Craniofac Surg. 2024. ## About the author I am Dr. Walter Zamarian Jr., a plastic surgeon in Londrina, Brazil. My practice focuses on deep plane facelift surgery with fat grafting. Here I explain my approach, the available evidence, and the limits of each treatment. CRM-PR 17.388 · RQE 15.688 [Read about my training and practice →](https://www.walterzamarianjr.com/us/walter-zamarian/) This article provides general information and does not replace an individual medical consultation. 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