The aim of surgery is to reshape the cartilage and pull the ear closer to the head. The cartilage can be reshaped in two ways, with stitches and by weakening or cutting the cartilage. It has been shown that when the cartilage is weakened on one side it will curl away from that side.
Both these methods are used to reshape the antihelix and reposition the concha. Sometimes both methods are used at the same time. If the concha is very large a small part may also be removed. Other parts of the ear may be reduced in size by removing part of the cartilage although some surgeons prefer to do this as a separate operation.
The cartilage is reached by making an incision in the skin behind the ear. The incision is closed with stitches that may need to be removed. Sometimes the earlobe will also be repositioned closer to the ear and made smaller. The surgery may be performed under a local anesthetic in adults, but in children, and some adults, a general anesthetic is preferred.
After surgery the skin is allowed to redrape over the new shape and held in position with dressings which mold the ear.