Asymmetry
The ears stand back from the head in different ways or have a different curl shape.
CONDITION / EARS
Deformation of the ear after otoplasty.
Complications after otoplasty can be early — a hematoma or infection in the first days — and late: the ear is asymmetric, protruded again, pressed too hard, seams or a rough scar are visible. Late deformities are corrected by repeated surgery when the tissues have healed.
CONCEPTUAL VISUALIZATION- What it is
- The ear after otoplasty has the wrong shape: asymmetric, protruded again, too pressed, seams or a scar are visible.
- How common
- In a review of 28 studies (3,493 patients), recurrence or reoperation was 5%.
- When corrected
- When the swelling subsides and the scar stabilizes; the terms are determined by the surgeon during the examination.
- Who treats it
- A plastic surgeon who performs repeated operations and reconstruction of the ear.
01 / WHAT IS ITWhat is
What is
deformation after otoplasty.
Otoplasty is an operation that presses the protruding ears to the head. It is usually safe and most people are satisfied with the results. But sometimes the result is not the same: one ear is different from the other, the protrusion returns or, on the contrary, the ear is pressed so hard that it looks unnatural.
Doctors divide complications into early — in the first 14 days after surgery — and late. Early ones include hematoma, bleeding, infection, skin necrosis or wound separation. To the late - stitches that cut through the skin, scars, increased sensitivity, asymmetry and unsatisfactory appearance. Re-operation is mostly done precisely because of the late ones.
A distinction is made between insufficient correction - the ear has stuck out again - and excessive, when the ear is pressed too much. Overcorrection is a more difficult problem: the skin behind the ear is missing, and the cartilage is permanently damaged, so both have to be restored.
Otoplasty is often performed at a young age, and an unsuccessful outcome can impair quality of life. Therefore, it is important not only to correct the form, but also to understand why it has changed.
This is general information. The doctor will tell you what will suit you after the examination.
02 / SIGNSHow does it look
How does it look
bad result
In the first weeks after otoplasty, the ears hurt, are numb, and bruises around them are to be expected. We talk about deformation when the shape is not the same even after healing.
The ear stuck out again
The bulging has returned completely or partially - relapse or insufficient correction.
The ear is pressed too hard
The ear "stuck" to the head; sometimes the middle is pressed harder than the top and bottom - the so-called telephone ear.
Seams are felt or cut through
Threads can be felt under the skin behind the ear, or a nodule has come out through the skin.
Sharp ridges and fractures
Sharp folds, corners or irregularities are visible on the cartilage - they occur after techniques where the cartilage is cut or thinned.
A rough scar or keloid
The scar behind the ear is thick, raised, itchy, or growing beyond the incision.
Keloid of the auricle03 / REASONSWhy the ear?
Why the ear?
changes shape
The surgeon first finds out exactly how the first operation was done: it depends on what can be corrected and how.
Relapse
The ear moves away from the head again. In a study of 705 children, 1.3% had repeat surgery due to recurrence; according to the authors, recurrence depends on the experience of the surgeon.
The seams were cut
Threads holding the cartilage pass through the thin skin behind the ear. In a series of 142 patients, sutures were palpable or visible in 9.1%, cut through in 6.3%.
Overcorrection
The ear is pressed too much: the skin behind the ear is missing, and the cartilage is permanently damaged.
Cartilage incisions
Techniques where the cartilage is cut or thinned can leave irreversible deformation; suture methods are considered safer.
Hematoma or infection
Blood under the cartilage membrane disrupts its nutrition: without treatment, infection, necrosis of the cartilage and permanent deformation of the ear are possible.
Scars
Some people are prone to rough scars. In a study of 705 children, 2.2% had hypertrophic scars, and all required reoperation.
04 / SEEK MEDICAL ADVICE
When to seek medical advice?
Deformation after otoplasty, which has already healed, is a planned situation: it does not require emergency care. But in the first days and weeks after the operation, sometimes there is a hematoma or infection of the cartilage. They are treated immediately, without waiting for healing, because without treatment the cartilage can deform.
103 immediately if:
- bleeding from a wound that does not stop;
- the blood is gushing, bright red and hard to stop;
- very frequent breathing;
- confusion, slurred speech;
- the skin has become bluish, pale or mottled;
- very high or very low temperature, severe chills;
- a rash that does not go away when pressed.
Do not delay a visit to the doctor:
Immediately - to the surgeon who operated, and if it does not work - to the reception department: after surgery, the pain in or around the ear is severe and increases, the ear is swollen or tense. On the same day: to the surgeon who operated, or if that is not possible, to any surgeon, if there is bleeding under the bandage, the ear is red and hot, the wound is oozing pus, the sutures have come apart, the fever has risen, or any other unexpected symptoms have appeared. In the coming days: if the seam protruded or came out through the skin behind the ear, see a surgeon. Planned: asymmetry, a protruding or excessively pressed ear, ridges of cartilage, a rough scar - they are evaluated when the swelling subsides and the scar stabilizes; you can see a doctor even earlier.
05 / DIAGNOSTICSAs estimated,
As estimated,
what went wrong
- Conversation
When and where was the operation performed, what method was used, were there hematoma, infection, repeated interventions; what exactly does not suit you. Take the statement if you have one.
- Examination of both ears
The surgeon compares the ears with each other: the distance from the head, the shape of the folds and curl, the condition of the skin and the scar behind the ear.
- Evaluation of cartilage
Is the cartilage intact, are there fractures, ridges, are the seams palpable; Is there enough skin behind the ear?
- Photo in standard angles
For reoperation planning and comparison.
06 / TREATMENTHow to fix
How to fix
unsuccessful otoplasty.
A repeat operation is planned for a specific deformity: first they find out what exactly went wrong and how the first operation was done, and then the technique is chosen. Sometimes several techniques are combined.
01
The first days and weeks
Early complications are treated immediately.
- Hematoma
- The blood is drained and a pressure bandage is applied so that it does not accumulate again.
- Infection
- Cartilage infection is treated as soon as possible: without treatment, the cartilage can deform.
- What to expect
- The ears are sore and numb for several weeks, the bruises last about two weeks, and the stiffness of the ears may last for several months.
02
Repeat operation
The method is for specific deformation.
- The ear stuck out again
- Cartilage is re-modelled with back sutures, if necessary, the overly deep cup of the auricle is reduced.
- The seams were cut
- The suture is removed, and the new sutures are closed with a flap of tissue behind the ear. In a series of 142 patients, a simplified flap without understitching did not reduce suture perforation; the authors suggest that the flap should be sutured to the cartilage.
- The ear is pressed too hard
- Both skin and cartilage are restored: skin is added with a graft or flap, cartilage with a fragment from an auricle or a rib.
- Severe deformation
- Small contour defects are corrected with cartilage from the concha of the second ear. If more than a quarter of the ear or more than two of its folds is deformed, according to a series of 49 patients, costal cartilage is recommended, as in ear reconstruction.
03
Scars and result
- A rough scar
- According to international guidelines, silicone gel or plates are considered the first choice for the prevention and treatment of hypertrophic scars and keloids. Hormone injections into the scar are also used.
- Keloid
- It is excised only with additional treatment, because it tends to come back. In a review of 85 articles on earlobe keloids, excision with hormone or radiation therapy resulted in a longer recurrence-free period than excision alone.
- Relapse
- Prolapse can return: in a review of 28 studies (3,493 patients), recurrence or reoperation was 5%, and in a meta-analysis of 14 studies of cartilage-sparing otoplasty, it was the most common complication — 4.27%.
07 / AT THE VALIKHNOVSKYI INSTITUTE
How
How
we treat it.
The consequences of an unsuccessful otoplasty at Dr. Valikhnovskyi's Institute of Surgery are corrected in the direction of "Growing an ear" - the same one that restores the auricle after injuries and with microtia. A repeat operation is planned when the swelling subsides and the scar after the previous one stabilizes.
CLINIC SERVICE
We grow an ear
Auricle with microtia and anotia, after injuries, burns and removal of tumors, consequences of unsuccessful otoplasty.
View service
What we do for this condition
- Re-modeling of cartilage — in case of recurrence or insufficient correction, the cartilage is modeled with back sutures, if necessary, the overly deep cup is reduced.
- Removal of seams and flaps — sutures that are cut or felt are removed, and new ones are closed with a patch of fabric behind the ear.
- Correction of too pressed ear — skin is added with a graft or flap, cartilage is restored with a fragment from a shell or rib.
- Costal cartilage with severe deformation — if a large part of the ear is deformed, the shape is restored with cartilage from the rib — as in case of loss of part of the ear.
- Treatment of scars — silicone gel or plates, hormone injections into the scar; keloid is excised along with additional treatment.
- Early complications — the hematoma is drained, the cartilage infection is treated as soon as possible.
Rostislav Valikhnovskyi
Plastic surgeon, candidate of medical sciences, founder of Dr. Valikhnovskyi Institute of Surgery.
How treatment works with us
- Photo onlineSend front, back and side photos of both ears and, if available, a statement of previous surgery.
- ConsultationExamination of ears, cartilage and scar; finding out how the first operation was done and what went wrong.
- PlanWhat to fix, with what methods and when - after the swelling subsides and the scar stabilizes.
- SurgerySutures, a flap, a skin or cartilage graft — depending on the deformity, sometimes several are combined.
- RecoveryBandage and examinations until healing; how much to protect the ear from pressure and contact sports, the surgeon will say.
08 / QUESTIONS AND ANSWERSCommon
Common
questions
Short answers. What is right for you, the doctor will tell you during the consultation.
How long after otoplasty can a repeat operation be performed?
When the swelling subsides and the scar stabilizes after the previous operation. The surgeon determines the exact time during the examination. Early complications — hematoma or infection — are treated immediately.
The ear hurts and is swollen after the operation. What to do?
In the first weeks, the ears hurt and become numb - this is expected. If the pain is severe and increases, or the ear is swollen and tense, immediately contact the surgeon who performed the operation, and if this does not work, go to the emergency department. If the ear is red, bleeding under the bandage, or the temperature has risen, go to the surgeon the same day.
Why did the ear protrude again?
This is a relapse or insufficient correction. In a meta-analysis of 14 studies of cartilage-sparing otoplasty, recurrence or reoperation was the most common complication. They are corrected by re-modeling the cartilage with back sutures.
The ear is pressed too hard. Can this be fixed?
Yes, but it is more difficult than insufficient correction: the skin behind the ear is missing and the cartilage is damaged, so both are restored - the skin with a graft or a flap, the cartilage with a fragment from a shell or a rib.
A thread is felt behind the ear. Is it dangerous?
A felt thread is a late complication, not an emergency. But if the suture has come through the skin, see a surgeon in the next few days. Such a seam is removed, and new seams are closed with a flap if necessary.
The first operation was performed in another clinic. Can this be fixed?
Yes. The surgeon will first find out exactly how the first operation was done, so take the medical record if you have one and a photo of the ears before the operation. What can be really corrected in your case, the doctor will tell after the examination.
Can the deformity return after repeated surgery?
Such a risk cannot be excluded: recurrence is one of the most frequent complications of otoplasty in general. Therefore, a plan is made based on the cause of the deformity, and after the operation, the surgeon's recommendations regarding the bandage and ear protection are followed.
Sources
16 sources · systematic reviews, meta-analyses, scar guidelines, research and the NHSshowCollapse
- Complications after prominent ear correction: A systematic review of the literatureJournal of Plastic, Reconstructive & Aesthetic Surgery, 2017doi:10.1016/j.bjps.2017.05.033 ↗
- Complications of Cartilage Sparing Otoplasty: A Systematic Review and Meta-AnalysisJournal of Craniofacial Surgery, 2024doi:10.1097/SCS.0000000000009976 ↗
- Complications of otoplasty: a literature reviewJournal of Plastic, Reconstructive & Aesthetic Surgery, 2009doi:10.1016/j.bjps.2008.06.043 ↗
- Revision otoplasty: an algorithmPlastic and Reconstructive Surgery, 2012doi:10.1097/PRS.0b013e31825dc363 ↗
- Understanding the unfavorable result after otoplasty: an integrated approach to correctionPlastic and Reconstructive Surgery, 2011doi:10.1097/PRS.0b013e31821e7113 ↗
- Ear reconstruction following severe complications of otoplastyJournal of Plastic, Reconstructive & Aesthetic Surgery, 2008doi:10.1016/j.bjps.2008.06.017 ↗
- Posterior Perichondrioadipodermal flap: A Versatile Option for Revision OtoplastyAnnals of Plastic Surgery, 2020doi:10.1097/SAP.0000000000001939 ↗
- Does postauricular fascial flap reduce suture complications in otoplasty?Journal of Plastic Surgery and Hand Surgery, 2018doi:10.1080/2000656X.2018.1444618 ↗
- Comparison of Cartilage-Scoring and Cartilage-Sparing Otoplasty: A Retrospective Analysis of Complications and Aesthetic Outcome of 1060 EarsPlastic and Reconstructive Surgery, 2018doi:10.1097/PRS.0000000000004241 ↗
- A retrospective analysis of complications and surgical outcome of 1380 ears: Experience review of paediatric otoplastyInternational Journal of Pediatric Otorhinolaryngology, 2020doi:10.1016/j.ijporl.2020.110302 ↗
- Managing Auricular Hematoma: An Emergency Medicine Narrative ReviewThe Journal of Emergency Medicine, 2025doi:10.1016/j.jemermed.2024.08.021 ↗
- Updated scar management practical guidelines: non-invasive and invasive measuresJournal of Plastic, Reconstructive & Aesthetic Surgery, 2014doi:10.1016/j.bjps.2014.04.011 ↗
- Efficacy and Safety of Excision Combination Therapies for Earlobe Keloids: A Systematic Review and Meta-analysisAesthetic Plastic Surgery, 2024doi:10.1007/s00266-024-04092-0 ↗
- Ear correction surgery, including ear pinningNHS, 2023nhs.uk/tests-and-treatments/cosmetic-procedures/cosmetic-surgery/ear-correction-surgery ↗
- SepsisNHS, 2026nhs.uk/conditions/sepsis ↗
- Cuts and grazesNHS, 2026nhs.uk/conditions/cuts-and-grazes ↗
The figures on the page are from these sources.
Ear after surgery
not as desired?
Send a photo of both ears. The doctor will tell you what caused the deformity and how it can be corrected.