Prominent ear surgery: How much relapse occurs? Research findings on efficacy and complications

In prominent ear surgery (a procedure that reshapes the ear cartilage to bring the ear closer to the head), a meta-analysis showed that ear projection decreased from an average of 27.1 mm to 15.4 mm[1]. Relapse was reported in 2.8%, and revision surgery in 2.1%[1]. However, in adults with firm cartilage, relapse is reported to occur more frequently[2].

By how much does surgery bring the ear closer to the head?

The distance between the ear and head was reduced by nearly half on average. A meta-analysis of 18 studies involving 1,590 subjects (3,060 ears) showed that the distance from the ear rim to the head decreased from an average of 27.1 mm to 15.4 mm[1].

The average follow-up period was 24.5 months[1]. The average age of the subjects was 16.0 years, with children and young people predominating[1]. Results may not directly apply to adult surgery.

Some reports also indicate that after suture-based ear shaping surgery, quality-of-life scores improved and satisfaction was high[3].

What is the difference between the suture method and the cartilage-cutting method?

There are two main approaches: suture-based method that creates ear folds without cutting cartilage, and methods that cut or score the cartilage[3].

The cartilage-cutting method carries a higher risk of creating an uneven ear surface[3]. The suture method allows reshaping without leaving visible surgical scars on the front of the ear[3].

The Mustardé technique (a representative suture-based method for creating ear folds) is valued for its efficacy, safety, satisfaction, and short operative time[4]. Meta-analyses also demonstrate favorable outcomes with cartilage-preserving methods[1].

Who is more likely to experience relapse?

Relapse is uncommon, but certain patients are at higher risk. In meta-analyses, relapse occurred in 2.8%[1].

Adults with firm cartilage and those with ear height exceeding 5 cm experience higher rates of relapse[2]. Meta-analyses of complications with cartilage-preserving methods also identify relapse and revision surgery as potential complications[5].

What complications can occur?

The most common is extrusion of sutures left inside the ear through the skin. Overall complications were reported in 14.4%, with suture extrusion accounting for 5.4%[1].

Suture extrusion typically occurred more than one year after surgery and was relatively straightforward to manage[4]. Other reported complications include hematoma, wound infection, keloid, and skin necrosis[5].

It has been noted that differences in study populations and methods make it difficult to establish precise figures[5].

In studies using local anesthesia, operative time was shorter and pain control was better compared to general anesthesia[3].

What should you confirm before surgery?

During consultation, ask about the following points:

Method: suture-based or cartilage-cutting[3]

Relapse: whether your cartilage firmness and ear size affect relapse risk[2]

Suture complications: management if sutures extrude[1][4]

Anesthesia: local or general anesthesia[3]

Whether a particular method suits your ears cannot be determined from this article alone. During examination, have your cartilage firmness and ear shape evaluated, and confirm the relapse risk and method differences for your situation.