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Macrotia Ear Reduction For Smaller Ears

Excessively large ears can be reduced in size for a more proportionate appearance. Dr. Kasrai is the most experienced cosmetic otoplasty surgeon in Toronto.

When the ears are too large, they become the first thing that people notice when they look at you. Even while you talk to someone, they may not look at you in the eye because your ears distract them. I've seen how much of a negative impact it can have on the self-esteem of my patients. You may be suffering in the same way when you don't need to be.

You or your child may have macrotia

Macrotia is a congenital ear deformity that is marked by excessively large ears. To determine the presence of macrotia, I'll take a few measurements of your or your child's ears. The average length of a child's ear is about 6cm, and adults can vary from 6 to 6.5cm. In addition, the width and length are compared in a ratio. Generally speaking, the average ratio should be 50-55%, with men having larger ear dimensions overall. Macrotia may exist if this width to length ratio is different.

Please note that I do not perform surgery on children under 7 years old. The minimum age of patients is 7 years old.

Ear reduction otoplasty involves removing excess skin and cartilage. Doing so reduces the size of the upper or lower half of the ear, or both. It can be safely performed on children and adults.

Unique point: over 15 years of experience and thousands of procedures performed

I have performed more than 2,000 ear surgeries over the 15 years I've been a board certified plastic surgeon. To date, I continue to perform these type of surgeries on a weekly basis. This makes me the most experienced otoplasty surgeon in Toronto.

I perform both cosmetic and reconstructive ear surgery to treat not just macrotia, but also several other simple to complex issues affecting the ear contour.


Unique point: a gentle and accommodating manner toward children patients

Otoplasty is one of the more popular plastic surgery procedures that is performed on children. That's probably why the vast majority of my ear surgery patients are under the age of 18 (it also helps that the surgery is covered by OHIP for patients under 18 years old). In addition, I previously practiced at the Hospital for Sick Children. There, I was part of a world-renowned team, treating children with significant congenital and traumatic ear injuries. My experience, and the fact that I'm a mother, too, enables me to be particularly sensitive to the unique needs of children going through surgery.

Unique point: techniques that preserve ear cartilage

The ears are very delicate structures that have minimal blood supply. Complications that result from improper surgical techniques can be disastrous. For example, infection can cause the destruction of cartilage that will impact the shape of your ear. For this reason, I've designed my ear reduction techniques to minimize anything that will compromise the state of cartilage in your ear. My careful and precise techniques allows me to have one of the lowest complication rates in the country.

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Beautiful results from ear reduction surgery rely on taking measurements of the ear before surgery, then carefully planning an approach that will achieve proportions that are harmonious. – Dr. Leila Kasrai

What will happen during your surgery

This procedure is accomplished in three to six hours. Anesthesia is administered.

A small incision is made in the back of the ear. Through this incision, excess cartilage and skin are removed to reduce the size of the ear. The remaining tissue is then resculpted to form an overall smaller ear shape.

Recovering from your surgery

  • Dressings, bandages and sutures removed after a week
  • Some discomfort
  • A week off of work or school

Bulky dressing is placed after your surgery to protect your ears, and after about a week, it is removed, along with any undissolvable sutures.

Some soreness and discomfort may be felt, but this can be alleviated with prescribed pain medication.

You or your child will need to stay home from work or school for about week. During this week, quiet rest is necessary to promote healing. However, it's important you don't spend all day in bed. You should get up regularly to keep your circulation going. While you sleep, a headband should be worn for the first three months to protect your ears from bending or being pulled forward.

Sports that require the use of helmets can be played after a week, but vigorous activity and contact sports should be avoided for at least six weeks. Extra care should be taken when playing, particularly on the playground.

A balanced ear size

Ear reduction surgery can achieve wonderful results in my patients. My patients no longer feel that their ears are the focal point of their appearance, which is exactly what they wanted from their surgery. And their scars, well hidden behind their ears, make any traces of surgery virtually invisible.

Frequently asked questions about macrotia treatment

What is macrotia?

Macrotia is the medical term for excessively large ears. This is different from protruding ears, which may be proportionately sized but only stick out.

How do you treat macrotia?

I treat macrotia by first determining a size of ear that would be harmonious with your head and facial features. Then, I remove excess skin and cartilage to reshape the ears, making them smaller. I minimize the amount of modification done on the cartilage to preserve it.

Ear reduction surgery is a relatively uncommon procedure.

How old do I have to be to get this surgery done?

I've safely performed this type of otoplasty surgery on children and adults.

Will it hurt?

The procedure is performed under anesthesia. This means you won't feel anything during your surgery. Usually, little discomfort is felt during recovery as well.

Will people be able to see my scars?

The scars tend to be well hidden behind the ear, in natural creases.


I'm extremely careful when performing surgery, as I know how delicate the cartilage and other tissues of the ear can be. However, you should still be aware of the risks involved:

  • Infection in the cartilage, which can cause scar tissue (can be treated with antibiotics)
  • Blood clot on the ear
  • Asymmetry
  • Reactions to anesthesia

There is a higher risk in patients who are smokers, are diabetic or have poor circulation.