Ear Surgery

The antihelix is the inner curved ridge of the ear that, when properly formed, creates the primary fold holding the upper and middle thirds of the ear close to the head. When this fold is deficient or flat, the ear protrudes — the most common anatomical contributor to prominence.

The concha is the deep, bowl-shaped cavity of the ear adjacent to the ear canal. When the conchal cartilage is excessively deep, or its angle relative to the mastoid is too obtuse, the entire ear is held away from the head. This is a distinct contributor that requires its own surgical management and is often present alongside antihelical deficiency.

Many patients present with contributions from both the antihelix and the concha, which is why a single technique rarely suffices and the operative plan must be tailored to the individual anatomy.

Less common, but also assessed and addressed where it contributes to the overall appearance of prominence or asymmetry,

Antihelix reshaping through controlled cartilage weakening.

The Chongchet technique involves making a series of precise, shallow parallel scoring incisions on the anterior (front) surface of the auricular cartilage in the region of the deficient antihelix. These incisions selectively weaken the inherent spring of the cartilage — without cutting through it — allowing it to bend into the desired antihelical fold when the posterior skin is closed.

Anterior scoring produces a smooth, rounded antihelical fold that closely mimics the curvature of a naturally well-formed ear. Because the technique works with the cartilage’s own mechanical properties rather than relying on suture tension alone, it is particularly effective in patients with stiffer or thicker cartilage, and produces a fold that is both natural in contour and less susceptible to suture-related complications over time.
ek also assists healing.

Permanent antihelical fold creation through cartilage-to-cartilage fixation.

Mustárdé sutures are the foundational technique for creating and defining the antihelical fold. Permanent, non-absorbable horizontal mattress sutures are placed through the posterior cartilage, drawing the scapha and conchal cartilage together to recreate the antihelical ridge. The number, spacing, and tension of these sutures are calibrated to the degree of antihelical deficiency and the specific contour required.

When used in combination with anterior cartilage scoring, Mustárdé sutures complement the mechanical weakening of the cartilage with active, precise positioning — allowing a controlled, symmetric fold to be created and held in place permanently. This combination is Dr Sparks’ standard approach for antihelical correction.

Conchal setback with or without conchal bowl reduction.

Where conchal excess or protrusion is a contributor to prominence — either alone or alongside antihelical deficiency — Furnas conchomastoid sutures are used to set the conchal bowl back against the mastoid fascia. These permanent sutures draw the conchal cartilage directly toward the skull, reducing the auriculo-cephalic angle and bringing the whole ear closer to the head.

In cases where the conchal bowl is genuinely excessive in depth or volume rather than simply angulated, conchal bowl reduction may be incorporated — excising a carefully measured ellipse of conchal cartilage before the Furnas sutures are placed. This ensures that the concha is not simply rotated back but genuinely reduced to an appropriate size, producing a more lasting and proportionate correction.

The decision to perform conchal reduction alongside Furnas plication is made on the basis of the clinical assessment and intraoperative findings, and is discussed with patients during pre-operative planning.

Most patients feel comfortable returning to desk work and social activities within seven to fourteen days, though individual variation applies. Exercise and strenuous activity are restricted initially and reintroduced gradually to minimise swelling and the risk of bleeding. Contact lens wear is typically resumed after a short interval, depending on the degree of swelling and dryness, with specific timing included in your personalised aftercare plan.

A soft compressive dressing is applied immediately following surgery and worn for the initial post-operative period to protect the ears and support the correction while early healing occurs.

Following the initial dressing phase, a soft headband is worn at night to protect the ears from inadvertent folding during sleep.

Typically 6 to 12 weeks at night; Dr Sparks recommends the longer end of this range for revision cases, where cartilage memory is stronger and the risk of recurrence is higher.

Most noticeable in the first 7 to 14 days; the final position and contour of the ears continues to settle as swelling fully resolves over the following weeks.

Most patients return to school or desk work within 7 to 10 days; contact sports and activities with risk of ear trauma are restricted for a minimum of six weeks.

Otoplasty is primarily a cosmetic procedure, but its impact extends well beyond appearance — particularly for children, for whom prominent ears can be a significant source of self-consciousness, social difficulty, and psychological distress. Addressing a correctable concern at an appropriate age can meaningfully improve a child’s confidence and wellbeing. For adults, the procedure offers a permanent solution to a long-standing concern that may have affected self-image for many years.

Yes — and this is the central goal of Dr Sparks’ approach. Over-corrected ears that sit flat against the head or appear pinned are the hallmark of poorly planned otoplasty. Dr Sparks’ technique is designed to produce a correction that restores normal proportion and position without eliminating the natural three-dimensional contour of the ear. The aim is an ear that looks as though it was always meant to be there.

Prominent ears most commonly result from one of two anatomical variations — an underdeveloped antihelical fold, excess depth or angulation of the conchal bowl — or a combination of both. Identifying which of these is present, and to what degree, is what determines the surgical plan. This is why a careful clinical assessment is an essential part of the consultation process.

Surgery is generally appropriate once the ear has reached near-adult size and the cartilage has developed sufficient stability to hold the correction reliably. The ideal timing varies between individuals and is discussed in detail during consultation. Dr Sparks’ experience in paediatric otoplasty, developed under Dr Richard Theile at Queensland Children’s Hospital, informs a conservative approach to timing that prioritises both surgical success and the child’s readiness.

For school-age children, planning surgery during school holiday periods is strongly recommended. It allows the child to recover in a comfortable, low-pressure environment, provides adequate time for visible swelling to settle before returning to school, and avoids the social self-consciousness that can accompany the early post-operative period. Dr Sparks’ team can advise on appropriate booking windows aligned with the school calendar.

No. Dr Sparks uses absorbable sutures to close the skin incision, meaning that suture removal is not required. This is particularly appreciated in a paediatric setting, where minimising post-operative clinic visits and discomfort is an important consideration.

Paediatric otoplasty is performed under general anaesthesia, planned and administered by a specialist paediatric anaesthetist. Dr Sparks works with experienced anaesthetic colleagues to ensure that the perioperative experience is as smooth and well managed as possible for both the child and their family.

No. Otoplasty can be performed successfully in adults of any age, provided they are in good general health. Many adult patients have lived with a long-standing concern about their ears and find that the procedure provides a result and a level of confidence they had not anticipated was achievable. The techniques are adapted where necessary to account for the characteristics of adult cartilage, which is typically stiffer and less pliable than in children.

Adult otoplasty is typically performed under general anaesthesia or deep sedation, depending on the patient’s preference and the extent of the procedure. Both approaches are discussed during the pre-operative assessment.

Mustárdé sutures are permanent, non-absorbable horizontal mattress sutures placed through the cartilage of the ear to create and define the antihelical fold. They are the foundational technique for correcting antihelical deficiency and are calibrated in number and tension to the specific anatomy of each patient. In Dr Sparks’ practice they are routinely used in combination with anterior cartilage scoring to produce a fold that is both precisely shaped and durably held.

Anterior cartilage scoring (the Chongchet technique) involves making a series of precise, shallow incisions on the front surface of the ear cartilage to weaken its inherent spring and allow it to fold into the antihelical shape. By working from the anterior surface, the technique produces a smooth, rounded fold rather than the sharp or irregular ridges that can result from posterior scoring. It is particularly effective for patients with stiffer cartilage where sutures alone may not achieve an adequate or lasting correction.

Furnas sutures are permanent stitches placed between the conchal cartilage and the mastoid fascia behind the ear to pull the conchal bowl back against the skull and reduce the auriculo-cephalic angle. They are used when the concha is identified as a contributor to prominence — either alone or in combination with antihelical deficiency. In cases where the conchal bowl is genuinely excessive in depth, a small amount of conchal cartilage may also be removed (conchal reduction) before the Furnas sutures are placed.

Because prominent ears frequently have more than one anatomical contributor. Correcting the antihelix alone when the concha is also prominent will leave a partial result; addressing the concha without the antihelix will do the same. Dr Sparks’ assessment identifies all contributing factors and the operative plan is built to address each of them — achieving a correction that addresses each component.

The headband protects the ears from being inadvertently bent or folded forward during sleep — the most common cause of recurrence in the early healing period when the cartilage is still adapting to its new position. It is a simple and important protective measure that significantly reduces the risk of the correction unwinding before healing is complete.

The headband is worn at night for 6 to 12 weeks. Dr Sparks typically recommends the longer end of this range for revision cases, where prior cartilage manipulation increases the tendency for the tissue to return toward its original position. Specific guidance is provided at each post-operative review.

Yes. Revision otoplasty can address an unsatisfactory prior result, though it is technically more demanding than primary surgery. Prior cartilage manipulation alters the tissue’s mechanical behaviour, and scar formation affects the skin’s mobility and the options available for re-correction. Dr Sparks assesses each revision case individually and constructs an operative plan that targets the specific anatomical cause of the problem rather than simply repeating the previous approach.

The most common indications for revision include recurrence of prominence (particularly if the initial correction was partial or relied on sutures alone without cartilage modification), under-correction of one side producing asymmetry, over-correction producing an unnaturally flat or pinned appearance, and irregular or sharp contours from previous cartilage work. Each of these has a different technical solution and is discussed in detail during consultation.

Yes. Earlobe repair and reshaping is a straightforward procedure that can address split lobes from earring trauma, stretched or elongated lobes from heavy earrings or gauges, and age-related earlobe ptosis or excess. The procedure is performed under local anaesthetic and produces a clean, symmetric result with a fine scar that is very well concealed.

Yes, once healing is complete — typically after three to four months. Re-piercing through the repaired area is straightforward, and Dr Sparks’ team will advise on appropriate timing during your post-operative follow-up.