October 12, 2026 | Ear Surgery, Earlobe Repair, Otoplasty
A mother brought her daughter in on a Thursday. The girl had already learned to hold her hair a certain way. The mother wanted to know two things: whether it could be fixed, and whether they should wait until she was older. I answered the first question in about ninety seconds. The second one took longer, because my honest answer is not the cautious one people expect.
Here is what I actually said in that room, and in a consult later the same week with an adult who came in about his earlobes. Identifiers removed.
“Can this be fixed?”
“This is something easy to fix. If you look at most people’s ears, they have more of a fold here. This fold is missing, and there is a little excess of the bowl, so we have to tuck it in. Everything is done through an incision behind the ear. We place sutures that go through the cartilage, and the ear is set closer to the head so it is not protruding anymore. Sometimes the upper part sticks out a little, so I tuck that in as well so it is flat.”
“How long does it take, and will she be asleep?”
“The surgery takes about an hour to an hour and a half. We usually do it with a little IV sedation. It is outpatient, so she can go home the same day.”
“What is the recovery?”
“Recovery is pretty easy. There may be a little soreness. For the first week you wear a headband, like a tennis band, that keeps the ears in place so everything heals. After a week, you only use it at nighttime for another week, and then you are done. At seven days we take out the sutures.”
“During recovery it is important not to accidentally pull on the ear, which is why she wears the band. In the beginning she may be a little sensitive at the incision, since some people are sensitive in the ears and can feel some discomfort for a while. We have a long-acting anesthetic, Exparel, that we can place that lasts about three days so you do not feel it as much early on.”
“Will it hold, or will they pop back out?”
“The surgery is usually very effective. Most of the time it works once and it is permanent. Occasionally, if one of the sutures breaks, an ear can pop back out and we would go back and reapply that suture, but the risk of that is low, less than five percent.”
“She is still growing. Will they stick out again?”
“Our ears and our nose keep growing for life, which is why older people have larger ears. But after surgery the ear grows tucked against the head, so it will not flap out.”
“Should we wait until she is older?”
“From experience with many patients, this is better to do early rather than later. I see a lot of adults who were bullied their whole life and come at 40 or 50 to take care of it. Doing it early gives more benefit. For smaller children we have to go to the hospital for general anesthesia, but she is at a good age where we can do it comfortably with sedation, and she will not feel anything.”
That is the part I want parents to hear. The operation is an hour. What it prevents can run thirty years.
“My earlobes hang too low. Can you make them smaller?”
This was the adult consult, conducted in Spanish. My words, translated.
“This is a fairly common surgery, and we can do it with local anesthesia; you do not need general anesthesia. So what I do is I make an incision here, like this. You are going to have a fine line, but really you will not notice it. And with that I can remove some of the lobe and then bring it up here, and you would end up with something smaller, a normal size.”
“When I finish, if I see that they still flare out to the sides, sometimes I put an incision back here to pull it inward, so that it does not stick out, so they do not look like they are spreading.”
“This procedure normally takes about thirty to forty-five minutes, with local anesthesia. You come in and go home the same day. You can really resume calm activity, driving. What we do not want you to do is any exercise, probably for about two weeks, so that they do not open up.”
“Do the stitches have to come out?”
“You are going to have sutures that will be visible for seven days. At seven days we take everything out.”
“There are internal ones that absorb on their own, but when we want a really fine scar we need to use a thread that is very, very fine, finer than hair, and that one goes on the outside so it does not leave marks. If we use something absorbable in the skin, it can leave marks afterward. I do not know if you have seen people who have something like train tracks.”
“When we have patients from out of town, we put in ones that do fall out on their own, but those usually leave a bit of a mark. So it is preferable to use these that are blue because they do not leave a mark.”
“Can I see what it will look like first?”
“There really is not an exact way to show you. But you can get a good idea. You are going to end up with a normal ear. You are not going to have that excess.”
“Really, with the ear, the ideal is that nobody sees it, right? In this case, obviously, those lobes are noticeable when people look, and after this surgery nobody is going to notice that.”
“Can you pin my ears back at the same time?”
“There is a surgery, the otoplasty, to pin them closer to the head. For that we make an incision back here and then we bring it closer. And that can be done at the same time if you wanted.”
“I can tell you that you have what we call a protrusion, but it is moderate, not severe, because you do have the fold; the fold is formed. There are people who do not have the fold formed. So mostly it is that you have a little excess of what we call the conchal bowl, which pulls the ear outward. So it is just a pinback.”
“That one we would do with a little sedation, and it takes a bit more time, about an hour and a half, but we can do both things at the same time. I can tell my coordinator to give you both packages, and then you can decide.”
“I tore my earlobe on an earring.”
That is an easy fix under local anesthesia, about fifteen minutes per ear. I excise the torn edges of the earlobe and suture them back together. Stitches stay in for seven days, then a small tape goes over the area. We can re-pierce in about four weeks. Many people come in with one lobe fully torn and the other partially torn, and it usually makes sense to repair both at the same sitting.
“A piercing left me with a keloid.”
“What we do is numb the area, then I cut out the keloid itself and re-suture it. We put in a little bit of Kenalog, which is a steroid, so that it prevents it from coming back. There is always a risk it can come back, the risk is about ten to twenty percent. But a lot of times when we clean it up well and suture it well, you will not have any more problems.”
“If we start seeing it getting hard or wanting to come back, you have to come in right away and we put in a little more steroid to keep it from doing that. It is a quick procedure, maybe twenty minutes, just local anesthesia, so you can get back to normal activity, just no exercise for about ten days.”
Book a consultation
Ear work is the smallest surgery I do and some of the most satisfying. An hour under sedation for a pinback. Half an hour under local for the lobes. Fifteen minutes a side for a tear. If any of the above sounds like your ears, come in and let me look.
I am a double board-certified plastic surgeon, a Mayo Clinic fellowship alum, and a Clinical Associate Professor of plastic surgery at Texas Tech University Health Sciences Center.
Call the office at (915) 590-7900, text us at 1-866-814-0038, or book a consultation at drworldwide.com.
#StayBeautiful
