Question 1

Which Otoplasty technique is appropriate?

Accepted Answer

Selecting and combining the correct techniques is essential to achieve optimal results. The auricle consists of different anatomical regions and can be divided into three horizontal thirds:

the upper third,
the middle third behind the ear canal, and
the earlobe.

Each region requires a careful individual analysis and specifically tailored corrective techniques.
In principle, cartilage shape can be modified in several ways:

Gentle scoring of cartilage to allow controlled bending
Permanent sutures to stabilize cartilage in its new position
Thinning of soft tissue behind the ear to rotate the auricle closer to the head
Selective removal of cartilage

I place particular emphasis on correcting the auricle with gentle and minimally invasive surgical concepts. In a scientific publication, I described an especially tissue-sparing approach that avoids scoring incisions and removal of cartilage. With this method, dressings can usually be removed after one to two days, and the operated ear soon appears inconspicuous.
The relatively short skin incision is typically hidden within the fold behind the ear. The resulting scar is barely visible. The incision is closed with dissolving sutures, so suture removal is usually not necessary—an important advantage, especially for children.

Question 2

Suture Otoplasty technique

Accepted Answer

I have been performing the suture technique for many years. This method—where no conventional skin incision is made—has lost importance overall.
Its advantages include small skin punctures (approximately one to two millimeters). Disadvantages include limited effectiveness for certain parts of the auricle, particularly the middle third, and the possibility of late suture extrusion, which may be associated with less permanent results.
I am pleased to advise you on all established otoplasty techniques and, of course, leave the informed decision entirely to you.

Question 3

From what age can Otoplasty be performed?

Accepted Answer

The auricle reaches full growth at approximately six years of age. From an anatomical and medical standpoint, otoplasty can therefore be performed from this age onward.
I recommend considering otoplasty when the child has developed good insight, is motivated and participates in the decision making process, which often occurs somewhat later, typically between 12 and 16 years of age.

Question 4

Is Otoplasty performed under anesthesia?

Accepted Answer

All otoplasty techniques can be performed under local anesthesia, sedation, or general anesthesia. In children, general anaesthesia is usually required, adults frequently prefer sedation. The procedure is always performed on an outpatient basis.

Question 5

Minimally - invasive techniques in Otoplasty

Accepted Answer

I place particular emphasis on minimally – invasive surgical techniques in otoplasty and associated procedures. Complications following otoplasty are often associated with methods that involve cutting or transecting the cartilage. I make every effort to avoid aggressive scoring or transecting techniques and prefer complete preservation of the cartilage of the ear.

Question 6

Revision Otoplasty

Accepted Answer

Revision procedures may be necessary if the result of a previous correction is unsatisfactory or not durable. Corrections may also be required to correct surface irregularities, changes of contour, unsatisfactory proportions, excessive adherence of the ear to the head, or loss of the fold behind the ear.
I frequently perform revision otoplasty for correction after unsatisfactory previous procedures. A personal examination is often necessary to determine the optimal treatment strategy. An initial assessment can be provided after reviewing photographs and the operative report, when available.

Question 7

Correction of the cup ear deformity

Accepted Answer

The so-called cup ear is a congenital deformity in which the helical rim is folded inward and protrudes. The ear typically also protrudes from the head.
Correction may slightly reduce the size of the ear, which is usually not conspicuous. I perform cup ear corrections regularly—under general anesthesia in children and typically under sedation in adults. Results can be viewed in the “Before and After Photos” section.

Question 8

Reconstruction of a missing helical rim

Accepted Answer

Absence of the helical rim may be congenital or acquired. In both cases, the helical rim can be reconstructed. This procedure may slightly reduce ear size, which is usually inconspicuous.
I perform this procedure regularly, typically under twilight sedation and on an outpatient basis. Results are available in the “Before and After Photos” section.

Question 9

Reduction Otoplasty (Macrotia correction)

Accepted Answer

Some ears not only protrude, but are also excessively large. This can be corrected through auricular reduction surgery, which is technically more demanding and requires reshaping of the helical rim as well as shortening of the earlobe.
I usually perform this procedure under sedation and on an outpatient basis. Results can be viewed in the “Before and After Photos” section.

Question 10

Aftercare following otoplasty – FAQs

Accepted Answer

Common questions after auricular correction include:

How long will I miss work?
When can my child return to school?
When is swimming or sports possible?
When can glasses be worn after otoplasty?
How long does the dressing remain in place?

The following recommendations apply only to patients treated by me and should be confirmed during a personal consultation.
After surgery, the ears are protected with a thick, soft dressing. This can usually be removed the next day or the day after and replaced with a headband. I recommend obtaining two to three wide, non-tight headbands (e.g., yoga-style headbands).
You may shower and gently clean the ears with mild soap once the dressing has been removed. The incision behind the ear should be cleaned and kept moist with the prescribed ointment for 10 days. Suture removal is not necessary, as the sutures dissolve on their own.
Many patients are able to return to work or school after just a few days.
The headband is usually worn at night for 10 days. Light sports activity may be resumed after two weeks and gradually increased. Swimming and bathing are typically allowed after four weeks. Glasses can often be worn again after a few days.
During sports, a headband should be worn for six months. Sauna use should be avoided for about six weeks. Overall, the ears should be protected from sun exposure for one year using a waterproof sunscreen with a high SPF (50).
Temporary sensory disturbances or skin sensitivity may occur and usually resolve over time.

Question 11

Before-and-after photos – Otoplasty

Accepted Answer

Representative results of otoplasty and associated procedures can be viewed via the “Before and After Photos” link.

Question 12

Costs and preliminary inquiry

Accepted Answer

If you send us photographs of your face, I will be happy to provide a non-binding preliminary assessment for your otoplasty or auricular correction procedure and estimated costs.
Photos should be taken against a neutral background, from approximately 2 meters distance, from the front and side, with face and neck filling most of the frame. Please send them to praxisteam.gassner (at) gmail.com, including your name, gender, date of birth, address, and treatment request.
I respond personally. By submitting your data electronically, you consent to electronic communication and acknowledge that data transmission in both directions occurs at your own risk.

Question 13

Expertise

Accepted Answer

Special focus on otoplasty and associated procedures
Emphasis on minimally - invasive, tissue-sparing techniques
Advanced and atypical surgical methods
Subspecialty training (Fellowship), University of Washington
Ten years as senior attending physician and section head at the University ENT Department Regensburg, with a focus on plastic and reconstructive facial surgery
Surgical training at the Mayo Clinic
Medical licensure in the United States
Board Certified Facial Plastic Surgeon (ABCFPRS, EBCFPRS)

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Treatments / Otoplasty (Auricular correction & Reconstruction)

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