Otoplasty: Surgical correction of protruding ears
Otoplasty, the surgical procedure to reshape the ears, permanently corrects protruding ears – a safe procedure that has been tried and tested for decades.
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Important note
This article is for information purposes only and is not a substitute for a medical diagnosis or advice. If you are unsure, or if you require a personalised treatment plan, it is essential that you consult a qualified specialist.
Protruding ears, often colloquially referred to as „bat ears“, are one of the most common congenital deformities of the outer ear. Although they are medically harmless, they cause significant psychological distress for many children and adults. Otoplasty, better known as ear pinning surgery, is a safe procedure that has been tried and tested for decades to permanently correct this deformity.
This article provides a comprehensive explanation of the anatomical cause of protruding ears, the modern surgical techniques available, and what you can expect from the procedure.
What is an earmould?
Otoplasty is a surgical procedure to correct the shape, size or position of the outer ear. By far the most common use is to correct protruding ears.
The aim of the operation is to create an aesthetically pleasing, natural and symmetrical appearance for the ears that blends harmoniously with the rest of the face.
The cause: Why do ears stick out?
Contrary to popular belief, otoplasty is not about „sticking“ the ears down. The most common cause of protruding ears is a congenital weakness in the shape of the ear cartilage. In most cases, the so-called anthelix fold – one of the main curves of the auricle – is underdeveloped or missing entirely.
Another possible cause is excessive spacing between the auricle and the head (enlargement of the cavum conchae). This causes the ear to protrude more from the head. The aim of the operation is therefore to surgically reshape this missing fold of cartilage.
| Criterion | Conventional earmould fabrication (cut-and-sew technique) | Thread method (without an incision) |
|---|---|---|
| Cut/Scar | A fine, inconspicuous incision behind the ear | Just tiny incisions, virtually no scarring |
| Cartilage treatment | The cartilage is exposed, weakened (e.g. by scoring or incising it) and reshaped using internal sutures. If necessary, part of the cavum conchae is also reduced in size or attached to the bone. | The cartilage is not exposed, but is simply shaped using special, permanent sutures |
| Invasiveness | More invasive | Minimally invasive |
| Suitable for… | Almost all types of protruding ears, even where the cartilage is thick and rigid | Relatively soft, flexible cartilage and moderate misalignments |
| Shelf life | Very high, long-lasting stability | Less prolonged standing, higher risk of recurrence (e.g. suture rupture or loosening) |
Conventional earmoulds: the gold standard
This is the traditional and most commonly performed method. The surgeon exposes the ear cartilage via a discreet incision at the back of the ear. The cartilage is weakened by carefully thinning or scoring it, so that it can be shaped more easily. It is then secured in the desired position using internal, non-absorbable sutures, thereby permanently recreating the antihelix fold.
The thread method: the minimally invasive alternative
This method does not involve making an incision in the skin. The doctor uses a needle to pass special, permanent sutures through the skin and cartilage and ties them in a knot under the skin at the back of the ear. Tightening the sutures creates the anthelix fold and pulls the ear back against the head.
Risks and the importance of the right surgical cover
Otoplasty is a routine procedure with very low risks. However, as with any operation, there are specific risks:
- Post-operative bleeding or bruising
- Wound-healing disorders or infections (particularly perichondritis)
- Asymmetry of the ears
- An unnatural appearance (ears that look as though they have been „glued on“)
- A recurrence, i.e. the ear partially returns to its previous position (higher risk with the suture method)
As the costs of treating complications or of any necessary revision surgery are not always covered by health insurance, a Consequential Costs Insurance financial security.
Frequently Asked Questions (FAQ) about earmoulds
The cost of a custom-made ear mould for an adult is usually between 2,500 and 4,500 euros.
For children and young people, the cost of the procedure is often covered by health insurance if psychological distress (e.g. due to teasing) is confirmed. For adults, otoplasty is almost always regarded as a purely cosmetic procedure and must be paid for out of pocket.
The ideal time is often during the pre-school years, at around 5–6 years of age. By this age, the ear is almost fully developed, but the cartilage is still soft and easily mouldable. However, the procedure can be carried out without any problems at any later stage in life.
Once the head dressing has been removed (after about 1 week), a headband must be worn for several weeks (often 4–6 weeks) – particularly at night – to protect the results and prevent the ears from accidentally being bent out of shape whilst sleeping.
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