Before surgery: what to prepare
Stop aspirin, ibuprofen, naproxen, fish oil, vitamin E, ginseng, and ginkgo for 7–10 days. No alcohol for 48 hours. Wash your hair thoroughly the morning of surgery. Bring a soft beanie or wide headband for the trip home if you don't want the bulky dressing visible. If you wear earrings, remove them before arrival and leave them out for the first 6 weeks. Plan to sleep on your back for at least 4 weeks; if you are a side-sleeper, practice for a week before surgery.
The day of surgery
Otoplasty is performed under local anaesthesia with sedation in most adult cases, occasionally general for children or anxious patients, runs 1.5–3 hours, and discharges same-day. You leave with a bulky head bandage covering both ears and a small drain in rare cases. The ears feel numb, throbbing, and warm under the dressing. Sleeping is awkward because of the bandage and because you must sleep on your back.
Days 1–3: peak swelling
Swelling and bruising are concentrated around the ears and feel like pressure under the dressing. Pain is usually moderate and well-controlled by oral medication. Keep the dressing dry; do not get it wet during showers, face-only washing for the first 48 hours. Sleep on your back. The ears can throb when you stand up after lying down for a long time as blood flow shifts.
Week 1: stitches out, bruising fades
First dressing change is usually at day 2–3, when the bulky bandage is exchanged for a softer compression band that wraps around the head and holds the ears in place. Bruising and swelling are dropping. Sutures come out around day 7–10. The ears look more pinned than they will eventually settle and the surgical line behind the ear is pink and visible from behind but invisible from the front.
Weeks 2–4: back to public
The compression headband is worn continuously for the first 1–2 weeks, then at night only for another 2–4 weeks. Office work and public situations from week 1 once the bulky dressing is replaced, the slim compression band is easy to hide under a beanie. Mild swelling and asymmetry can persist into week 4. No sleeping on the side of the head until at least week 4 because lateral pressure can disrupt the cartilage healing. Asian patients have a higher background rate of hypertrophic and keloid scarring; the retroauricular incision is well-hidden but ask the surgeon about silicone gel or sheeting starting at week 3–4 if you have a personal or family history of keloid.
Months 2–3: swelling resolves
The ears settle slightly outward from their week-2 position as the cartilage relaxes. This is expected and the surgeon over-corrected to allow for it. The retroauricular scar fades from pink toward your skin tone. Sleep position can return to normal around week 6–8 for most patients. Numbness behind the ears is improving.
Months 6–12: the final result
Final position is set by month 6. Cartilage memory occasionally pulls one or both ears slightly outward over the first year, which is the most common reason for late revision and is assessed at month 6 minimum. Scar maturation runs the full 12 months. The retroauricular scar should be invisible from any normal viewing angle by month 6.
Red flags: when to call the clinic
Call the clinic the same day for: sudden severe pain under the dressing (possible haematoma, rare but a true emergency for cartilage because pressure can cause permanent deformity), increasing one-sided swelling, pus or yellow discharge, fever over 38.5°C, or skin behind the ear that turns dusky white or black. A haematoma after otoplasty must be drained within hours, not days, to prevent cauliflower-ear deformity. Perichondritis (cartilage infection, presents as a hot, red, exquisitely tender ear that gets worse rather than better) is a separate surgical emergency requiring IV antibiotics; left untreated it can also cause permanent deformity. Go to an emergency room for severe one-sided ear pain with fever and headache if the clinic is closed. Mild throbbing, intermittent itching as nerves recover, and asymmetric swelling between the two ears in the first week are not red flags.