Ear shape improvement (concha: outer ear)

Protruding -- or sticking out ears -- is type of congenital deformity.
The most common types are extra large concha and underdeveloped antihelix.
Very conspicuous malformations indicate clearly a need for surgery. In cases where malformation is not so evident but the ears look unattractive and affect the patient’s self esteem, surgery is a matter of personal choice.

Correction of outer ear malformation should be started at 6 or 7 years of age, when ear concha formation is almost complete; moreover, it is better to perform this correction before the child enters a long term school community. Nevertheless, this type of surgery is not contraindicated for grown ups.

Состояние после реконструкции мочки.

Anesthesia

Local or general anesthesia is used depending on the patient’s age and psycho-emotional personality type. Nowadays, there are several methods for correcting protruding ears that provide satisfactory results.
Choice of method depends on the type of malformation, ear tissue texture, and age of the patient. Skin incisions are made on the back side of the ear concha. To reshape overly large concha, the excess portion is removed

Protruding ears otoplasty main goals.

1. Corrections of all irregular proportions primarily in the upper concha.
2. Correction of upper third of ear concha so that from frontal (full face) view 
the antihelix does not hide the helix

3. Correction so that antihelix is smooth and even along all its length.
4. Correction so that the cavity behind the ear is neither too small nor misshaped.
5. Correction to reshape a concha which clings too tightly to the head.
6. Correction to make both conchas more or exactly symmetric.

Postoperative pain 
Post-operative pain can last up to 24 hours, during which time painkillers are administered. 

Occasional, periodic postoperative pain occurs at a later time due to regeneration of the ear’s large sensory nerve branches, which were injured or severed during surgery.

Special elastic bandages are worn after surgery. Patients must stay at the clinic for 24 following the procedure; and then return for bandage replacement. Stitches are removed after about a week. It is recommended that the elastic bandaging be worn day and night for the first 2 weeks; and be worn for the following 2 weeks just at night to prevent ear concha bending. 
Possible Complications

Pain, significant swelling and dermahemia, in the operation site, can be signs that an infection process is developing, which may result in ear cartilage and skin necrosis. 
With the first signs of inflammation, patients must be re-hospitalized to be administered antibiotics. 
Hypertrophic or keloids scarring can develop mainly as a result of skin excision in the postaural fold area; which is difficult both to forecast and prevent. Minor scarring treatment is performed by conservative measures using silicone sheets and creams. Need for surgery (otoplasty) is indicated when ear concha is severely malformed. 
Perichondritis (infection of the skin that covers ear cartilage) is usually caused by inflamatory processes in ear concha tissues. The best prophylaxis for this is to take preventive measures against hematic abscess formation.

Otoplasty complications caused by inaccurate surgery techniques.

Rough and irregular separation of inner and outer cartilage skin to make notches may result in ischemia and tissues necrosis. When placing mattress sutures in patients with thick and firm cartilage, there is a risk of piercing cartilage tissues and recreating deformity. Lack of precision in placing sutures or notches when reshaping antihelix can lead to irregular contour. Cartilage dissection to increase flexibility may form sharp edges. Longer cartilage excisions in auricle area concha without additional skin separation tends to form unattractive, unnatural skin folds.
Incorrect stitching will place ears closer to head, perhaps leading to abnormally narrow auditory meatus (earhole).