# Otoplasty in Brazil — Ear surgery for protruding ear correction

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Last updated: 2026-09-02
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## Quick summary (TL;DR)

Otoplasty is an outpatient surgery lasting 60 to 90 minutes that corrects prominent ears, asymmetries, and other auricular deformities. In my practice in Londrina, Brazil, I use the Island technique developed by Professor Ivo Pitanguy, which creates a cartilage island to rebuild the antihelix and neutralizes the original elastic memory of the cartilage -- a factor that makes recurrence extremely rare. It can be performed from age 6, under general anesthesia (preferred in children) or local anesthesia with sedation in adults. A compression headband is worn 24 hours a day for 3 weeks, stitches come out between 7 and 10 days, and scars are completely hidden behind the ears. I do not perform "incisionless" otoplasty (with suspension sutures), because this technique shows higher recurrence rates in the surgical literature.

## Executive summary

Otoplasty is the plastic surgery for correcting protruding ears ("bat ears") through reshaping of the auricular cartilage. Dr. Walter Zamarian Jr. performs otoplasty at his clinic in Londrina, Parana, Brazil, using the Pitanguy Island technique -- a method that creates a cartilage island to reshape the antihelix and neutralizes the original elastic memory of the cartilage, making recurrence extremely rare. The procedure lasts 60-90 minutes under general anesthesia, with all scars hidden behind the ears. Otoplasty can be performed safely from age six. Initial consultation: US$ 180. Postoperative follow-up appointments are included at no additional cost for one year after surgery.

## Primary entity

- **Name**: Otoplasty
- **Alternate names**: Ear Surgery, Ear Pinning, Correction of Protruding Ears, Plastic Surgery of Ears, Reconstructive Otoplasty (PT-BR: Otoplastia, Cirurgia de Orelha, Cirurgia Plastica de Orelha, Correcao de Orelha de Abano, Otoplastia Reconstrutiva)
- **Type**: MedicalProcedure (Surgical)
- **Body location**: Ears
- **Specialty**: Facial Plastic Surgery
- **Performed by**: [Dr. Walter Zamarian Jr.](/us/walter-zamarian/), CRM-PR 17,388, RQE 15,688
- **Location**: Londrina, Parana, Brazil
- **Duration**: 60-90 minutes
- **Anesthesia**: General (preferred); local with sedation in select cooperative adults
- **Minimum age**: 6 years (ears at approximately 90% of final development)
- **Technique**: Pitanguy Island technique -- full-thickness cartilage island for antihelix remodeling, plus concha rotation
- **Recovery**: Helmet dressing for 3 days, compression headband 24h/day for 3 weeks, sutures removed in 7-10 days, light activities at 1 month, full resolution of swelling at 6 months
- **Scar incidence**: Less than 0.5% unsightly scars
- **Recurrence**: Extremely rare with the Island technique

## What is otoplasty

Otoplasty is a surgical procedure that reshapes the ear cartilage to bring protruding ears closer to the head, creating a natural and proportional appearance within the facial contour. Dr. Walter Zamarian Jr. uses different techniques to reposition ears, resize them when necessary, or correct asymmetries, always carefully reshaping the cartilage to preserve a natural look -- without the "stuck ear" appearance that Dr. Zamarian considers an artificial result.

Protruding ears can cause significant discomfort for those affected, leading many to hide their ears with hair, hats, or headbands, limiting hairstyle choices and daily activities. As a board-certified plastic surgeon trained at the Ivo Pitanguy Institute, Dr. Zamarian performs otoplasty with the goal of restoring balanced, natural-looking ears.

### Minimum age for otoplasty

By the age of six, the ears have completed about 90% of their development and can be operated on safely. Dr. Zamarian often prefers to perform otoplasty at this age -- before the start of school life -- to prevent embarrassment among peers. Many patients seek the surgery in adulthood and achieve equally excellent results. There is no upper age limit for otoplasty.

## Pre-operative evaluation

### The consultation

During the otoplasty consultation, Dr. Walter Zamarian Jr. evaluates three fundamental elements:

| Element | Description | Surgical correction |
|---------|-------------|-------------------|
| Antihelix | A cartilage fold giving curvature to the outer ear; when "flattened," it projects the ears forward | Redesigned using the Pitanguy Island technique; in small children with pliable cartilage, scraping alone may suffice |
| Concha projection | Excess concha cartilage can project ears nearly 90 degrees from the head | Rotated backward without cartilage removal; calculated hypercorrection applied (ears open gradually over 3 weeks) |
| Asymmetries | One ear often protrudes more than the other | Minimized to become imperceptible; in rare severe deformities, partial or total auricle reconstruction may be needed |

### Anatomical details evaluated

**Helix** -- The outermost fold of the ear, running from the root to the lobe. In cases of lop ear or cup ear, the curvature is very pronounced, sometimes caused by a horizontal cartilage fold crossing the antihelix, requiring helix remodeling with a spring made from concha cartilage.

**Antihelix** -- A curved Y-shaped fold located just anterior to the helix. In most protruding ears, the antihelix is absent. Otoplasty recreates the antihelix through cartilage remodeling, reducing upper pole projection.

**Darwin's tubercle** -- A fold or projection on the helix at the superior-external point. When very prominent and contributing to ear projection, Dr. Zamarian may surgically reduce it during otoplasty.

**Lobe** -- The lower part of the ear, without cartilage. In cases of excessive size (common in the elderly), otoplasty can reduce the lobe by removing a wedge near the facial insertion. The procedure can also repair torn earring holes through anterior zetaplasty and posterior suture.

**Tragus** -- The cartilage protuberance in front of the ear at the external auditory canal. A flattened tragus can be a stigma from a previous facelift when the surgeon tries to hide the scar behind the tragus. Releasing the cartilage from scar tissue restores its projection.

**Root** -- The uppermost insertion of the ear. Rarely operated on in otoplasty, but useful in helix flap (Antia flap) procedures for repairing loss of substance in the middle or upper thirds of the helix via a V-Y flap.

**Concha** -- The smooth, concave area posterior to the external acoustic meatus. Contains cartilage ideal for hyaline cartilage grafts (for rhinoplasty, for example). When excessively projected, Dr. Zamarian detaches the concha from the mastoid and repositions it posteriorly, typically combined with antihelix remodeling.

### Pre-operative exams

Dr. Walter Zamarian Jr. requires the following exams before otoplasty:

- Complete blood count
- PT (Prothrombin Time) with INR + aPTT (Activated Partial Thromboplastin Time)
- Creatinine
- BUN (Blood Urea Nitrogen)
- Fasting blood glucose
- Total proteins and fractions
- Urinalysis
- EKG (Electrocardiogram)
- Pre-operative cardiac clearance (evaluation by a cardiologist)

### Anesthesia

Dr. Zamarian performs otoplasty under general anesthesia, which provides total comfort during the 60-90 minute procedure. In selected cases of cooperative adults, local anesthesia with sedation may be a viable alternative, but general anesthesia remains the preference for the safety and comfort it provides -- especially in children.

## The surgery (Pitanguy Island technique)

The procedure begins with precise marking and removal of excess skin in the posterior region of the ears. Dr. Zamarian then outlines and creates the cartilage island that will shape the new antihelix -- this is the essence of the Island technique learned from Professor Ivo Pitanguy. The cartilage is projected with absorbable sutures, and the new contour of the ear begins to emerge. The auricular cartilage is then detached from the mastoid and rotated backward, correcting the excessive concha projection. All suturing is performed exclusively behind the ears, remaining completely hidden.

Otoplasty is an outpatient procedure: the patient goes home the same day, as soon as the effects of anesthesia wear off, with a padded helmet-shaped bandage that protects the ears without causing thermal discomfort. This bandage remains for approximately three days.

### Scars

All surgery is performed in the posterior region of the ears, so scars are completely hidden and usually present excellent aesthetic results. Patients with a tendency to keloids should be evaluated before surgery -- the retroauricular region has a slightly higher risk of keloid formation, similar to the shoulders and pre-sternal region. In Dr. Zamarian's experience, the incidence of unsightly scars after otoplasty is less than 0.5%.

## Post-operative recovery

| Milestone | Timeframe |
|-----------|-----------|
| Helmet-shaped bandage worn | First 3 days |
| Compression headband worn 24h/day | 3 weeks (removed only for bathing) |
| Suture removal | 7-10 days |
| Light physical activities, sleeping on side, wearing glasses | After 1 month |
| Swelling considerably improved | First month |
| Complete swelling resolution | Up to 6 months |
| Ear sensitivity fully restored | Progressive, up to 6 months |

Pain intensity varies between patients -- some feel moderate discomfort, while others feel practically none. Effective analgesic medications, including OTC pain medication such as acetaminophen, ensure a comfortable post-operative period.

## Recurrence

Recurrence is when the ears start to project again after surgery. The Island technique used by Dr. Zamarian involves a full-thickness incision through the cartilage -- a technical detail that neutralizes its original elastic memory and, in his experience and in the surgical literature, makes recurrence extremely rare. This is one of the major differentiators of the approach learned from Professor Pitanguy: by building a cartilage island and reshaping the antihelix contour, the result tends to remain stable long-term, year after year.

## Reconstructive otoplasty

Otoplasty is a broad term that encompasses any plastic surgery of the ears, not only protruding ear correction. Dr. Walter Zamarian Jr. treats various conditions at his clinic in Brazil:

- **Lop ear** -- excessively curved helix folding downward
- **Cup ear** -- constricted ear with hooding of the helix
- **Microtia** -- underdeveloped or small ear
- **Anotia** -- congenital absence of the ear
- **Post-trauma reconstruction** -- repair after injuries or accidents
- **Post-cancer reconstruction** -- repair after skin cancer removal
- **Lobe repair** -- torn or elongated earring holes

Each deformity individualizes the treatment, which can range from simple cartilage relaxation with minimal skin removal, to using cartilage from the other ear, to total auricle reconstruction using rib cartilage from the chest. Each patient is evaluated individually and clearly informed about realistic possibilities of improvement.

## Video

**Video**: [Otoplasty: Pitanguy Island Technique for Protruding Ears | Complete Guide](https://www.youtube.com/watch?v=N6ajMZjQVH8) -- Dr. Walter Zamarian Jr. explains everything about otoplasty with the Island technique of Professor Ivo Pitanguy for correcting protruding ears in Brazil, including pre-operative evaluation, surgical steps, and recovery.

## How much does otoplasty cost in Londrina, Brazil?

Otoplasty pricing varies with the complexity of the case -- straightforward bilateral correction of prominent ears, unilateral cases, combined earlobe repair, and reconstructions of deformities such as lop ear or cup ear all have different price points. The total investment includes surgical fees, the anesthesia team, disposable materials, and hospital/facility time. Dr. Zamarian provides a personalized quote during the first consultation, after assessing the ears in person, choosing the best technique, and estimating the operating time. For international patients, the cost of ear surgery in Brazil is typically a fraction of what it would be in the US or Europe, even when factoring in the trip.

### Does insurance cover otoplasty in the US?

Most US private insurers -- Aetna, Blue Cross Blue Shield, UnitedHealthcare, Cigna, Humana -- classify otoplasty as cosmetic surgery and will not cover it in adults. The usual exceptions are congenital deformities (microtia, anotia), traumatic injury reconstruction, and post-cancer reconstruction, which are considered reconstructive. In children under 18, some carriers cover correction of significantly protruding ears when documentation shows functional or psychosocial impact, but pre-authorization and medical records are mandatory. Medicaid policies vary by state, and original Medicare generally does not cover cosmetic otoplasty. Dr. Zamarian's clinic in Brazil works on a private (out-of-pocket) basis: the quote is discussed openly during the consultation, with no surprises.

## Otoplasty compression headband: how to use it, for how long, and where to buy one

The compression headband -- also called an otoplasty headband, ear compression garment, or ear band -- is the single most important piece of the recovery kit. It holds the ears in their new position while the cartilage heals, controls the gradual reopening caused by surgical hypercorrection, and helps reduce swelling. Without it, results can fall short of expectations even when the surgery itself is flawlessly executed.

### How long should I wear the compression headband after otoplasty?

Dr. Zamarian instructs patients to wear the headband 24 hours a day for the first three weeks, removing it only for daily showers. After that, keep wearing it overnight for another one to two weeks, totaling around 30 to 35 days. That transition protects the ears from pillow friction while the tissues finish healing and keeps the result durable.

### Where can I buy an otoplasty headband?

Ear compression headbands are sold at surgical supply stores, orthopedic supply stores, online specialty retailers (Amazon, Walmart, and medical supply websites all sell them under search terms like "otoplasty headband," "ear band post surgery," or "ear compression garment"), and some larger pharmacies. Order the right model before surgery, so it is ready on the day of discharge. Look for a model that compresses the ears snugly without squeezing the head so tightly that it causes headaches.

### Headbands for children, men, and women

Pediatric sizes with fun colors or patterns can make things easier for younger patients. Adults usually prefer neutral fabrics (black, gray, beige) that blend in under longer hair or a hat. During the first three weeks, hair partially covers the headband, and in the last one to two weeks many patients comfortably return to work -- men with shorter hair typically just explain the situation to colleagues.

## What do ears look like before and after otoplasty?

Before otoplasty, prominent ears project forward and form an angle greater than 30 degrees with the lateral plane of the head. The three most common anatomical findings are: a flattened antihelix (missing the curved "Y" fold), an excessively projected concha, and asymmetries -- one ear usually sticks out more than the other. Many patients hide their ears behind long hair, hats, caps, or headbands, limiting hairstyles and sports, and in children, leading to comments at school.

After surgery, the ears look proportional to the face, with a redesigned antihelix and a concha rotated backward. Dr. Zamarian always preserves some natural projection -- an ear that is fully flattened against the head looks artificial. The final result reveals itself gradually: during the first three weeks, swelling and the compression headband control the gradual reopening; between 1 and 3 months, the natural contour appears; and through month 6, residual swelling and ear sensitivity return to normal. The scars, completely hidden behind the ears, are essentially invisible in daily life.

Dr. Zamarian does not publish before-and-after photos on this website. The Brazilian Federal Medical Council (CFM) code of medical ethics restricts promotional use of patient images on public websites, even with written consent. During the in-office consultation, Dr. Zamarian shows real cases (with explicit patient authorization, in a private setting) so each patient can evaluate the pattern of results from his technique with full transparency. Verified patient reviews on Dr. Zamarian's Google Business profile are also publicly available.

## Incisionless otoplasty (thread lift ear pinning): does it work?

Incisionless otoplasty -- also called the closed technique, thread otoplasty, suture-only otoplasty, or stitch method -- is a procedure in which the surgeon passes non-absorbable sutures through small skin punctures, without an open incision, trying to fold the cartilage and reposition the ear. **Dr. Zamarian does not perform this technique.** Here is why.

The surgical literature shows that incisionless techniques have higher recurrence rates than traditional open techniques, because they do not break the elastic memory of the cartilage -- they only try to hold it mechanically with sutures. Over time, the cartilage tends to return to its original position, and the threads themselves can cause complications: extrusion (sutures poking back through the skin), infection, granulomas, and chronic discomfort. Patients whose internal otoplasty stitches come through the skin months or years later are a frequent complaint in this technique.

That is why Dr. Zamarian prefers the Pitanguy Island technique, with a posterior incision (hidden behind the ear) through the full thickness of the cartilage. In his experience and in the published literature, this approach neutralizes the original elastic memory and delivers the most stable long-term result. The difference between a technique that "mechanically holds" the cartilage and one that actually reshapes the cartilage itself is exactly what explains why recurrence is so rare with the Island technique.

## Bad otoplasty: how to spot it and what to do next

Signs of a bad otoplasty include: ears that are overcorrected and glued flat to the head (the "telephone ear" look), obvious asymmetry between the two sides, an antihelix with an artificial, sharp-edged contour, a deformed concha, hypertrophic or keloid scars, internal sutures coming through the skin, and recurrence of the original projection. Revision rates in the published literature range from 5% to 15%, depending heavily on the technique used and the surgeon's experience.

### Revision otoplasty (redo surgery)

Revision otoplasty is more complex than primary surgery: there is scar tissue, the anatomy has already been altered, and in some cases cartilage is missing and cannot simply be reshaped. Dr. Zamarian evaluates each case individually and, when indicated, performs the revision using cartilage grafts from the opposite concha or from a rib. The minimum interval between the first surgery and a revision is typically 6 to 12 months, so that healing is complete and the final result from the first operation has fully matured.

### How to avoid otoplasty regret

The factors that most contribute to regret are unrealistic expectations (wanting ears "perfectly flat," which looks artificial), not understanding the gradual reopening that happens over the first few weeks, choosing a technique with a high recurrence rate (like thread-only otoplasty), or -- most importantly -- choosing a surgeon without specific training in ear surgery. The best prevention is an honest consultation: ask how many otoplasties the surgeon performs per month, which technique they use and why, and request to see photos of real cases in the office. In the US, verify your surgeon's certification at abms.org (American Board of Plastic Surgery) or through your state medical board.

## Otoplasty in children: ideal age, newborn ear molding, and safety

Surgical otoplasty can be performed from age 6 -- the age at which the ears have completed about 90% of their final development. Dr. Zamarian often prefers to operate between ages 6 and 10, before the start of elementary school or early in it, so the child can avoid being teased by classmates. The procedure is safe at this age: it is performed under general anesthesia in a hospital setting, in roughly 90 minutes, and the child goes home the same day.

### Ear molding for newborns (EarBuddies and similar systems)

In babies up to approximately 3 months old, there is a non-surgical alternative: ear molding with devices such as EarBuddies, EarWell, or similar clinical systems. During the first weeks of life, the newborn's auricular cartilage is extremely pliable because of residual maternal estrogen, and the ears can be reshaped with specific devices that adhere to the skin. This treatment should always be supervised by a trained plastic surgeon or pediatric specialist. When started early enough (ideally in the first two weeks), ear molding can prevent the need for surgery later on.

Once that early window has passed, the molds lose effectiveness -- the cartilage stiffens, and only surgery will correct the deformity. So if you have a newborn with prominent or folded ears, see a plastic surgeon (or a pediatrician who refers directly) in the first weeks of life to explore the molding option before the cartilage matures.

## Who is qualified to perform otoplasty in the US and Brazil?

Otoplasty is a regulated surgical procedure, and under US and Brazilian law alike, it can only be performed by a licensed physician. The medical specialties formally recognized to operate on the auricle are:

- **Plastic surgeon** -- in the US, a physician certified by the American Board of Plastic Surgery (ABPS), following an accredited residency in plastic surgery. In Brazil, a physician with RQE (specialist registration) in Plastic Surgery, ideally with dedicated training in ear surgery. Dr. Zamarian's training was at the Ivo Pitanguy Institute in Rio de Janeiro, a world reference for teaching the Island technique for otoplasty.
- **Facial plastic surgeon / ENT (otolaryngologist)** -- a physician certified by the American Board of Otolaryngology-Head and Neck Surgery, or the American Board of Facial Plastic and Reconstructive Surgery (ABFPRS). ENTs and facial plastic surgeons are especially well trained for reconstruction in microtia, anotia, and complex congenital deformities, and many also perform cosmetic otoplasty.
- **Head and neck surgeon** -- for reconstructive cases after trauma or oncologic resection.

Before scheduling an otoplasty, verify credentials. In the US, confirm board certification via abms.org, the ABMS (certificationmatters.org) directory, or your state medical board. In Brazil, check the surgeon's registration at the CFM Portal (portal.cfm.org.br) and confirm the RQE for the specialty. Dr. Zamarian is an active member of the Brazilian Society of Plastic Surgery (SBCP) with CRM-PR 17,388 and RQE 15,688 -- all publicly verifiable. This level of caution matters especially given the rise of "quick courses" and "minimally invasive techniques" promoted by providers without a full plastic surgery residency.

## Keloid risk and otoplasty: who is more likely to develop one?

A keloid is an overgrowth of scar tissue in which collagen is laid down beyond the original wound margins, creating a raised, reddish, often itchy bump. The retroauricular region -- where the otoplasty incision lives -- has a slightly higher keloid risk, along with the shoulders, chest, and earlobes. In patients with a personal or family history of keloids, Dr. Zamarian assesses the risk carefully before recommending surgery.

### I have a history of keloids: can I still have otoplasty?

Yes, but with extra precautions. During the consultation, Dr. Zamarian reviews personal and family history, examines prior scars (vaccination marks, C-section, previous surgeries), and if there are clear signs of a keloid tendency, he may: (a) postpone surgery, (b) layer in preventive post-op treatments such as silicone sheeting, intralesional steroid injections, or laser therapy, or (c) treat any active keloid before operating. In patients without a history, standard wound care and routine follow-up are usually enough.

### Infected otoplasty: what to do

Infection after otoplasty is rare but serious, because it can compromise the cartilage -- a structure with limited blood supply. Warning signs include: increasing pain after the third day (when it should be getting better), redness, local warmth, yellowish or greenish discharge, and fever. If you notice any of these signs during recovery, contact your surgeon right away. Treatment involves systemic antibiotics and, in advanced cases, drainage and removal of any non-viable tissue. Prevention is best: proper dressing care, strict hygiene around the compression headband, and following the post-op prescription to the letter.

## Frequently asked questions about otoplasty

### At what age is it possible to have otoplasty?

By the age of six, the ears have completed about 90% of their development and can be operated on safely. Dr. Walter Zamarian Jr. often prefers to perform otoplasty at this age -- before the start of school life -- to avoid embarrassment among peers. Many patients seek the surgery in adulthood and achieve equally excellent results. There is no upper age limit for otoplasty.

### Does otoplasty leave visible scars?

No. Dr. Zamarian performs the entire surgery on the back of the ears, so the scars are completely hidden and usually result in excellent aesthetic outcomes. The incidence of unsightly scars after otoplasty is less than 0.5%.

### Can the ears revert after surgery?

In Dr. Zamarian's practice, recurrence is extremely rare. The Island technique learned from Professor Ivo Pitanguy uses a full-thickness incision through the cartilage and neutralizes its original elastic memory, which keeps the result stable long-term. Patients wear a compression headband 24 hours a day for three weeks to help protect that result.

### How long does otoplasty surgery take?

Dr. Zamarian performs otoplasty in 60 to 90 minutes, under general anesthesia, which is the preference for safety and comfort -- especially in children. The patient goes home the same day, as soon as the effects of the anesthesia wear off.

### What is the postoperative period like for otoplasty?

At the end of the surgery, a padded helmet-shaped dressing protects the ears for about three days. Then, a compression headband is worn 24 hours a day for three weeks. Sutures are removed between 7 and 10 days. After about a month, the patient can resume light physical activities, sleep on their side, and start wearing glasses again. Swelling improves considerably in the first month, but it can take up to six months to resolve completely.

### Does otoplasty correct asymmetries between the ears?

Yes. Asymmetries between the ears are quite common -- often, one ear protrudes more than the other. In the vast majority of cases, otoplasty minimizes these differences so efficiently that they become imperceptible in daily life.

### Is otoplasty only for protruding ears?

No. Dr. Walter Zamarian Jr. performs otoplasty for various conditions: correction of protruding ears, lop ear, cup ear, microtia, anotia, reconstruction after trauma or removal of skin cancer, among others. Each patient is evaluated individually and clearly informed about the real possibilities of improvement.

### What type of anesthesia is used in otoplasty?

Dr. Zamarian performs otoplasty under general anesthesia, which provides total comfort to the patient during the procedure. In selected cases of cooperative adults, local anesthesia with sedation may be a viable alternative, but general anesthesia remains the preference for the safety and comfort it provides -- especially in children.

### What is the Pitanguy Island technique?

The Island technique is the core of the otoplasty Dr. Walter Zamarian Jr. learned from Professor Ivo Pitanguy. It consists of building a cartilage island that shapes the new antihelix, with a full-thickness incision through the cartilage. This technical detail neutralizes the original elastic memory of the cartilage and reshapes the ear contour in a stable, durable way. The technique makes recurrence extremely rare.

### What tests are necessary before otoplasty?

Dr. Zamarian requires a complete blood count, PT with INR, aPTT, creatinine, BUN, fasting blood glucose, total proteins and fractions, urinalysis, EKG, and pre-operative cardiac clearance. These tests ensure that the surgery is performed with total safety.

### How much does otoplasty cost in Londrina, Brazil?

Pricing depends on the complexity of the case -- bilateral prominent-ear correction, unilateral surgery, combined earlobe repair, or reconstruction of deformities all have different costs. Dr. Zamarian provides a personalized quote during the first consultation, covering surgical fees, the anesthesia team, disposable materials, and hospital time. For international patients, ear surgery in Brazil is typically a fraction of US or European pricing, even factoring in the trip.

### Does insurance cover otoplasty in the US?

Most US private insurers -- Aetna, Blue Cross Blue Shield, UnitedHealthcare, Cigna, Humana -- classify adult otoplasty as cosmetic and do not cover it. Exceptions apply to congenital deformities (microtia, anotia), traumatic reconstruction, and post-cancer reconstruction. In children under 18, some carriers cover significantly protruding ears with documented functional or psychosocial impact, always requiring pre-authorization. Medicaid varies by state, and original Medicare does not cover cosmetic otoplasty. Dr. Zamarian's clinic in Brazil works on a private out-of-pocket basis.

### How long should I wear the compression headband after otoplasty?

Wear the compression headband (ear band) 24 hours a day for the first three weeks, removing it only for daily showers. After that, keep it on overnight for another one to two weeks, totaling around 30 to 35 days. The headband controls the gradual reopening of the ears and reduces swelling.

### Where can I buy an otoplasty headband?

Ear compression headbands are sold at surgical supply stores, orthopedic supply stores, online retailers (Amazon, Walmart, and medical supply websites list them under "otoplasty headband," "ear band post surgery," or "ear compression garment"), and some larger pharmacies. Order yours before surgery so it is ready on the day of discharge. Pediatric, men's, and women's models are available.

### Do you perform incisionless otoplasty (thread otoplasty)?

No. The surgical literature shows that incisionless, suture-only techniques have higher recurrence rates than open techniques, because they do not break the elastic memory of the cartilage -- they only hold it mechanically with threads. Threads can extrude through the skin, get infected, or cause chronic discomfort. Dr. Zamarian prefers the Pitanguy Island technique, with a hidden posterior incision, for its stable long-term result.

### What are the signs of a bad otoplasty?

Warning signs include: ears overcorrected and glued to the head (the "telephone ear" look), obvious asymmetry, an antihelix with an artificial or sharp-edged contour, hypertrophic or keloid scars, internal stitches coming through the skin, and recurrence of the original projection. Revision rates reported in the literature range from 5% to 15%, depending on technique and surgeon experience. Revision otoplasty is more complex than primary surgery and typically requires a 6-to-12-month interval after the first operation.

### Can infants have otoplasty?

Surgical otoplasty starts at age 6. For babies up to approximately 3 months old, there is a non-surgical option: ear molding with devices such as EarBuddies or EarWell. In the first weeks of life, auricular cartilage is extremely pliable because of residual maternal estrogen and can be reshaped with adhesive molding devices. Once this early window closes, the cartilage stiffens and only surgery will correct the deformity.

### Who is qualified to perform otoplasty?

Otoplasty can only be performed by a licensed physician. In the US, the specialists formally recognized to operate on the ear are: board-certified plastic surgeons (ABPS), facial plastic surgeons and ENTs (ABOtoHNS / ABFPRS), and head and neck surgeons for reconstructive cases. Verify credentials at abms.org, certificationmatters.org, or your state medical board. In Brazil, confirm the surgeon's registration at the CFM Portal and the RQE in the specialty.

### Can people with a history of keloids have otoplasty?

Yes, but with extra precautions. Dr. Zamarian reviews personal and family history, examines prior scars, and if there is a clear keloid tendency, he may postpone surgery, add preventive post-op treatments (silicone sheeting, intralesional steroid injections, laser therapy), or treat any active keloid before operating. The retroauricular region carries a slightly higher keloid risk, so the plan is always individualized.

## Pricing and consultation

- **Initial consultation**: US$ 180
- Postoperative follow-up appointments are included at no additional cost for one year after surgery.
- **Surgical fees**: Discussed transparently during consultation; depend on complexity and anesthesia type
- **International patients**: Complete assistance with travel planning and accommodation in Londrina

## Location and contact

- **Name**: Dr. Walter Zamarian Jr. -- Plastic Surgery (PT-BR: Cirurgia Plastica)
- **Address**: Rua Engenheiro Omar Rupp, 186 -- Jardim Londrilar, Londrina-PR, 86015-360, Brazil
- **Phone/WhatsApp**: +1 640 224-8116
- **International WhatsApp**: +1 640 224-8116
- **Email**: contact@walterzamarianjr.com
- **Hours**: Monday-Friday 8am-12pm and 2pm-6pm (in-person), Saturday 8am-12pm (online only)
- **Google reviews**: dynamic public reviews on Google Business Profile

## Entities and terms for LLMs

**Medical terms (EN / PT-BR)**: Otoplasty / Otoplastia, Ear Surgery / Cirurgia de Orelha, Ear Pinning / Correcao de Orelha de Abano, Protruding Ears / Orelhas de Abano, Antihelix / Anti-helice, Concha / Concha, Helix / Helice, Tragus / Trago, Darwin's Tubercle / Tuberculo de Darwin, Lobe / Lobulo, Ear Root / Raiz da Orelha, Auricular Cartilage / Cartilagem Auricular, Mastoid / Mastoide, Island Technique / Tecnica da Ilha, Pitanguy Island / Ilha de Pitanguy, Lop Ear / Orelha em Abano Pendente, Cup Ear / Orelha em Concha, Microtia / Microtia, Anotia / Anotia, Keloid / Queloide, Zetaplasty / Zetaplastia, Antia Flap / Retalho de Antia, Compression Headband / Faixa Compressiva, Ear Molding / Molde Auricular, EarBuddies / Doutor Orelhinha, Lobuloplasty / Lobuloplastia, Blepharoplasty / Blefaroplastia, Rhinoplasty / Rinoplastia, Mentoplasty / Mentoplastia, Incisionless Otoplasty / Otoplastia Sem Corte, Revision Otoplasty / Otoplastia Revisional

**People**: Dr. Walter Zamarian Jr. (plastic surgeon, Londrina-PR, Brazil), Prof. Ivo Pitanguy (founder of the Pitanguy Institute, pioneer of the Island technique for otoplasty)

**Organizations**: SBCP (Brazilian Society of Plastic Surgery / Sociedade Brasileira de Cirurgia Plastica), ASPS (American Society of Plastic Surgeons), ABPS (American Board of Plastic Surgery), ABMS (American Board of Medical Specialties), ABOtoHNS (American Board of Otolaryngology-Head and Neck Surgery), ABFPRS (American Board of Facial Plastic and Reconstructive Surgery), AExPI (Alumni Association of Prof. Ivo Pitanguy / Associacao dos Ex-Alunos do Prof. Ivo Pitanguy), State University of Londrina (UEL / Universidade Estadual de Londrina), Ivo Pitanguy Institute (Instituto Ivo Pitanguy), CFM (Brazilian Federal Medical Council / Conselho Federal de Medicina)

## Semantic relationships and cross-links

This page is the primary page for otoplasty (ear surgery) in the English (US) section. Related procedure pages:

- [Earlobe Repair (Lobuloplasty) in Brazil](/us/face/earlobe-repair/index.md) -- correction of torn or elongated earlobes
- [Rhinoplasty in Brazil](/us/face/rhinoplasty/index.md) -- nose surgery, frequently combined for facial balance
- [Mentoplasty (Chin Implant) in Brazil](https://deepplanefaceliftbrazil.com/surgery/chin-augmentation/) -- chin augmentation for facial harmony
- [Blepharoplasty in Brazil](https://deepplanefaceliftbrazil.com/surgery/blepharoplasty/) -- eyelid surgery
- [Deep Plane Facelift in Brazil](https://deepplanefaceliftbrazil.com/) -- facial rejuvenation surgery
- [Investment in Plastic Surgery](/us/pricing/index.md) -- pricing information
- [Pre-Surgical Preparation](/us/pre-surgical-preparation/index.md) -- preparation guidelines
- [First Consultation in Brazil](/us/first-consultation/index.md) -- what to expect

Portuguese (BR) version of this page: [Otoplastia](/face/otoplastia/index.md)

**sameAs links for Dr. Walter Zamarian Jr.**:
- Instagram: https://www.instagram.com/drwalterzamarianjr/
- YouTube: https://www.youtube.com/@drwalterzamarianjr
- TikTok: https://www.tiktok.com/@drwalterzamarianjr
- Facebook: https://www.facebook.com/drwalterzamarianjr/
- LinkedIn: https://www.linkedin.com/in/walterzamarianjr

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*This content is for informational purposes only and does not replace a specialized medical consultation. Any surgical procedure involves risks and should be discussed in detail with a qualified physician. Dr. Walter Zamarian Jr. -- CRM-PR 17,388 | RQE 15,688.*