Surgery to Correct Cauliflower Ears

The condition known as cauliflower ear can result from direct, blunt force trauma to the ear. The cartilage of the ear only gets its blood supply from the skin. Any blow to the ear hard enough to cause the skin to separate from the cartilage and blood to pool (hematoma formation) will cut off blood supply to the cartilage. This will deprive the ear cartilage of vital nutrients. If the ear is not treated immediately, the cartilage will turn white, shrivel, and fold in on itself, giving the ear the distinctive shape of a head of cauliflower.

Causes of Cauliflower Ear

Although cauliflower ear can occur as a result of any hard blow, the condition most often happens as a result of contact sports such as boxing, martial arts, or wrestling. Use of protective headgear can reduce the risk of developing cauliflower ear, but at least one study has shown that athletes are more likely to develop cauliflower ear during practice, rather than actual competitions, as they are less likely to wear headgear during practice bouts.

Other causes for cauliflower ear include ear piercings placed very high on the ear (referred to as industrial piercings). If not done properly, industrial piercings can lead to a type of infection known as auricular perichondritis, which may result in cauliflower ear if left untreated.

Symptoms of Cauliflower Ear

Common symptoms of cauliflower ear include pain, swelling, bruising, reddening, and deformity of the ear as the cartilage folds in on itself. In severe cases, there may be ringing in the ears, blurry vision, hearing loss, excessive bleeding (particularly if the ear sustains another hard blow), or headaches.


Nonsurgical: It will take an average of seven to 10 days for the fluid and blood buildup in the ear to harden. If the problem is caught before then, it is easily treated by draining the ear and using compression bandages. Antibiotics may also be prescribed to prevent further infection.

Surgical: Unfortunately, if the problem is not treated within that seven to 10 day window, the deformed cartilage will build up scar tissue and require more extensive surgery to correct. In moderate cases, the skin is lifted away from the affected area and the underlying scar tissue is carefully removed. The patient will then be given a custom molded splint to wear continuously for at least four weeks or more, depending on how quickly the ear heals.

In more severe cases, the goal is to save the unaffected ear cartilage or reconstruct the entire ear. This will be done using either rib cartilage or a porous polyethylene material that is used for other forms of facial implant surgery, such as cheeks or chins. The framework material is custom shaped for each patient, and then skin is grafted over the framework in order to form the new ear.

The staff at Jefferson Plastic Surgery treats many current and former athletes who have developed cauliflower ear. With time and care, the affected ear can often look as good as new. 

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Jefferson Plastic Surgery is located on the corner of 9th and Walnut streets in Center City, Philadelphia on the 15th floor of the Wills Eye Hospital Building.

Jefferson Plastic Surgery
840 Walnut Street - 15th Floor
Philadelphia, Pennsylvania 19107
Phone: (215) 625-6630
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