Otoplasty (Prominent Ear Surgery) in North Cyprus

Prominent ear appearance does not arise from a single cause. It results from one of three anatomical abnormalities, or a combination of them:

• Absent or underdeveloped anti-helix fold: In a typical ear there is a distinct inner ridge between the helix (outer rim) and the concha (bowl of the ear) — this is the anti-helix. When it is underdeveloped or flattened, the upper half of the ear opens outward and protrudes. This is the most common underlying cause.
• Conchal cartilage excess (conchal hypertrophy): When the concha — the central bowl of the ear — is unusually deep or wide, the entire ear moves away from the mastoid bone. In these cases the lower half of the ear also angles forward.
• Combined presentation: The most frequently encountered pattern in practice — both an insufficient anti-helix and excess conchal cartilage are present. The surgical plan in this situation requires a Mustardé + Furnas combination.

The earlobe (lobule) may also angle forward and, when present, this third component is included in the plan. A careful clinical examination at consultation establishes which component is dominant. The choice of technique depends entirely on this distinction. It is not simply a matter of "the ear is large" — how the ear is large determines the plan.

Otoplasty is one of the few aesthetic surgical procedures in plastic surgery that is commonly performed in childhood, and there is a clear anatomical rationale for this:

• By the age of five to six, the auricle has reached approximately 85% of its adult size. This is the practical threshold at which surgical outcomes will not change as the child continues to grow. Operating too early risks asymmetry or contour loss during the remaining growth phase.
• The period just before starting school is also psychosocially appropriate — it is a decision made before the child encounters visible difference in a peer environment. The classic window commonly discussed between surgeons and families is six to twelve years of age.
• There is no upper age limit for adults: While six years is the lower threshold, there is effectively no upper limit in practice. An adult in good health can undergo otoplasty in their thirties, forties, or fifties with no meaningful reduction in outcome. In older patients the cartilage tends to be firmer and more brittle, which influences the choice of technique.

Must surgery take place at age six? There is no definitive answer. The child's own awareness of the difference, the family's observations and the suitability of surgical conditions are all weighed together. This is not a decision that needs to be rushed — there is no closing window where "it will be too late".

Prominent ear appearance does not follow a formal classification system for visual severity, but three levels are recognised in clinical practice:

• Mild (auriculocephalic angle 30–35°, mastoid distance 2–2.5 cm): Usually only a flattened anti-helix fold is present. Mustardé sutures correct this efficiently; additional conchal manipulation is rarely needed.
• Moderate (35–45°, 2.5–3 cm): A mixed picture — both an insufficient anti-helix and conchal cartilage excess are present. The Mustardé + Furnas combination is the standard approach.
• Marked (45°+, 3 cm+): Significant conchal hypertrophy, cartilage rigidity and sometimes additional anatomical anomalies. Conchal cartilage scoring or partial excision may be required; if there is excess skin, additional planning in the retroauricular region is needed.

Severity classification is a clinical tool — it does not drive the decision on its own. The patient's age, cartilage flexibility, degree of asymmetry and expectations always shape an individualised plan. The two ears are rarely affected identically — performing a different amount of tissue manipulation on each side is standard practice. A "make both sides exactly the same" approach can actually worsen asymmetry.

We offer consultations online (Zoom or WhatsApp video call) or in person at our clinic. For paediatric patients, a parent's full involvement in the process is always required — the family participates together in the decision-making.

At the consultation we focus on four areas:

• Physical examination: The auriculocephalic angle, mastoid distance, anti-helix development, conchal depth and lobule position are all assessed. Skin type, cartilage flexibility and degree of asymmetry are noted.
• Psychosocial assessment in children: We listen to whether the child is aware of the difference, how it affects them in peer settings, and what they themselves think about the idea of surgery. Surgery is not performed on a child who does not want it — if a case is driven by family pressure rather than the child's own wish, the procedure is deferred.
• Health assessment in adults: Systemic conditions, anticoagulant use, smoking history, allergies and any previous ear surgery are reviewed. In patients with a tendency to form keloid scars, scar management is planned differently from the outset.
• Preliminary technique selection: Whether Mustardé sutures alone are sufficient, whether Furnas sutures need to be added, and whether cartilage scoring is required — a provisional plan is shared following the physical examination.

At the end of the consultation we give you a clear picture: whether you are a suitable candidate, which technique is appropriate, the approximate cost range (reference guide: €3,000–€4,000 on average), the recommended length of stay in Northern Cyprus, and what recovery to expect. The exact price for each patient is given after examination — the figure varies with case severity, type of anaesthesia and any additional procedures required.

Otoplasty techniques have been in use in plastic surgery practice for approximately 60 years. Today's gold standard is a case-specific combination of three approaches:

• Mustardé sutures (anti-helix creation): Where the anti-helix fold is absent or underdeveloped, permanent sutures — typically 4-0 Mersilene or a similar synthetic material — are placed through the cartilage via a retroauricular incision (behind the ear). These sutures create a new anti-helix fold and maintain it over the long term. They remain within the tissue and preserve the fold indefinitely. This technique is sufficient on its own in mild-to-moderate cases where anti-helix absence is the primary finding.
• Furnas sutures (concha–mastoid setback): In cases with conchal cartilage excess, the concha (ear bowl) is sutured directly to the periosteum of the mastoid bone, drawing the entire ear back towards the head. When conchal excess accompanies anti-helix insufficiency, Furnas sutures are applied alongside Mustardé sutures.
• Cartilage scoring (anterior scoring): Where the cartilage is firm and resistant, small incisions are made on the anterior surface of the anti-helix region to "train" the cartilage into the new fold. Scoring is more frequently required in adults and older patients where cartilage rigidity is higher. In children, whose cartilage is more flexible, sutures alone are generally sufficient.
• Conchal cartilage excision: In marked cases, a small amount of tissue may be removed from the conchal cartilage. This is a more aggressive step and, if taken too far, can lead to undesirable contour changes. Furnas setback is therefore attempted before excision in most cases.

Selection by case type:

• Child + mild presentation: Mustardé sutures alone are usually sufficient.
• Adult + moderate-to-marked presentation: Mustardé + Furnas + anterior scoring as required.
• Older patient + firm cartilage: Scoring plays a more prominent role.

All techniques are performed through a retroauricular incision (behind the ear, within the natural hairline shadow). There is no incision on the front surface — so the scar is not visible when looking at the ear from the front or side.

Typical procedure-day schedule:

• 08:30 — Arrival at clinic, final assessment, anaesthesia consultation (paediatric anaesthetist for child patients)
• 09:00 — Final marking and photographic documentation in the standing position
• 09:30 — Anaesthesia: in adults, local anaesthesia with sedation is the standard approach — the patient is relaxed and does not feel pain, without the need for intubation. In children, general anaesthesia is used — it is necessary for stillness and comfort throughout the procedure.
• 10:00 — Retroauricular incision (behind the ear, within the hairline), exposure of the anterior cartilage surface
• 10:15 — Mustardé sutures, Furnas setback and/or anterior scoring applied according to the case plan
• 11:00 — The contralateral side is addressed; the same steps are repeated with individually calibrated adjustments to account for asymmetry
• 11:30 — Skin closure, compression bandage applied
• Total duration: 1–2 hours (varies with case complexity)

At the end of the procedure a compression bandage is applied around the ears. The gentle pressure assists the cartilage in settling into its new position and reduces the risk of haematoma. Adult patients are generally discharged the same day after a few hours of monitoring. For paediatric patients, discharge is planned once full recovery from anaesthesia has been assessed, with an optional overnight stay available — at the family's preference.

Typical recovery timeline:

• First 24 hours: The compression bandage remains in place. A mild sensation of pressure is normal. Mild-to-moderate pain is managed with prescribed analgesics.
• 24–48 hours: The compression bandage is reviewed at the clinic and changed or removed as needed.
• Days 5–7: First post-operative appointment. Suture check, removal of any skin sutures. Compression bandage removed.
• Following 2–3 weeks: A soft elastic headband (similar to a sports hairband) is recommended for nights only. This prevents the ear from bending under pillow pressure during sleep.
• 2 weeks: Return to school and desk-based work is generally possible. In paediatric patients, return to school within 5–7 days is common.
• 4–6 weeks: Strenuous exercise, swimming and contact sports are to be avoided. The cartilage-settling process is completing during this period.
• 6 weeks: Full activity clearance.
• 3–6 months: Final contour result. The cartilage fully settles into its new position, the scar matures and residual swelling resolves — all are assessed at this point.

We remain in contact with you throughout every stage via WhatsApp. Parents of paediatric patients take an active role in the photographic follow-up process.

Related page: Medical tourism packages — transfers, accommodation and follow-up included

• Children aged six and over: Those whose ear development has reached approximately 85% of adult size, who are visibly bothered by the difference, and whose family also gives informed consent. The pre-adolescent years are the classic preferred window.
• Young adults and adults: No upper age limit applies in practice. Individuals in good health can undergo otoplasty in their fifties and sixties.
• Patients with one or both ears noticeably affected: Performing different amounts of manipulation on each side is standard practice.
• Good general health: Individuals without uncontrolled chronic conditions and not taking anticoagulants.
• Realistic expectations: Surgery brings the ear into better alignment with the plane of the head. It does not substantially change ear size.
• No keloid tendency, or a manageable skin type: Scar maturation in the retroauricular region is usually straightforward. In patients prone to keloid formation, a specific scar management plan is put in place.
• Non-smokers, or adults able to stop smoking two to four weeks before surgery: Cartilage healing is protected from the effects of smoking.

• Under six years of age: Ear development is not yet complete. Results may change during further growth. Surgery below this age is not performed except in exceptional circumstances.
• A child who does not want the procedure: If the case is driven by parental pressure and the child is not themselves bothered by the difference, surgery is deferred. The decision must be grounded in the child's own words.
• Active ear infection, outer ear canal problem or skin condition: These are treated first; surgery is then planned once resolved.
• Patients with a history of keloid scarring: There is a risk of keloid formation in the retroauricular region. An honest assessment is made before surgery and a scar management plan is established from the outset. In some cases, deferring is the right recommendation.
• Uncontrolled diabetes, coagulopathy or autoimmune conditions: An individual risk–benefit assessment is required.
• Body dysmorphic disorder (BDD) suspected: Surgery alone is not the solution. Psychological support takes priority.
• Previous failed otoplasty (revision case): Revision surgery is technically more demanding than a primary procedure — the cartilage and skin anatomy have been altered. A thorough preliminary assessment is essential.

A patient we say "this is not right for you" or "let's wait a little longer" to is more valuable to us than one we say "yes" to — because a decision forced against the clinical picture serves no one.

Otoplasty is often thought of as a "minor" procedure, but it demands a precise sense of symmetry, an ability to read cartilage, and sound judgement in combining techniques. Overcorrection leaves the ear pressed flat against the skull — the so-called "telephone ear" deformity. Undercorrection leads to relapse over time. The right balance is struck not by a single parameter but by the triangle of anti-helix formation + conchal position + lobule alignment.

Op. Dr. İbrahim Meyzin is a Specialist in Plastic, Reconstructive and Aesthetic Surgery, and a full member of the Cyprus Turkish Medical Association (CTMA), Registration No. 969. For otoplasty, he selects the correct combination of Mustardé, Furnas and scoring techniques according to each individual case — a single-technique default is not applied. In paediatric cases, anaesthesia coordination and family communication are central to the process. In adults, local anaesthesia with sedation is prioritised for comfort. He is personally present throughout every procedure — the model of "technicians operate, doctor oversees" is not practised at Nis Clinic.

Full academic background, certifications and publications: Doctor Profile — Op. Dr. İbrahim Meyzin

The otoplasty patient population divides into two groups: children aged six to twelve and young adults or adults. The needs of these two groups are not the same, and we design the process accordingly.

For paediatric cases:

• The consultation is two-directional — the child and the parent are each heard separately. The decision is grounded in the child's genuine wish.
• A paediatric anaesthesia consultation is completed before surgery.
• An optional overnight stay after the procedure is available, planned according to the family's preference.
• A written plan is shared with the family covering school return, compression bandage management and activity restrictions.

For adult cases:

• Local anaesthesia with sedation is the standard; same-day discharge.
• The WhatsApp contact line operates through the surgical team directly, not through a receptionist.
• Return-to-work planning (typically five to seven days) is discussed from the outset.

Geography is a practical advantage: one hour fifteen minutes from Istanbul; four to four and a half hours from the United Kingdom. After surgery, you can spend your five-to-seven-day recovery in a quiet stay on the Kyrenia coast.

Our clinics are located in Nicosia (main clinic), Kyrenia (on the coastline, medical tourism coordination) and Famagusta (eastern side of the island).

Otoplasty prices vary by clinic, surgical approach and type of anaesthesia:

• United Kingdom: €3,500–€6,000+
• Türkiye (quality clinics): €2,000–€3,500
• Nis Clinic (Northern Cyprus otoplasty package): €3,000–€4,000 average range

This guide figure varies according to the type of anaesthesia (adult local anaesthesia + sedation → standard; child general anaesthesia → towards the upper end), the technique applied (Mustardé only → towards the lower end; Mustardé + Furnas + scoring → mid-range; additional cartilage work → towards the upper end), length of stay (optional overnight) and any additional assessment requirements. The exact figure, tailored to each patient, is given after consultation and examination.

The package includes: airport transfer, two nights' accommodation (three if required), the procedure, anaesthesia, compression bandage, medications, follow-up appointments and six months of WhatsApp support. For paediatric cases, any additional charge for paediatric anaesthesia is discussed from the outset — there are no hidden fees.

If you are not simply looking for the cheapest option — if you value documented expertise and an honest candidacy assessment — you are in the right place.