Are you thinking about Ear Surgery in Vancouver? Ear Surgery, also known as Otoplasty, is a surgical procedure used to improve the appearance of the ears by correcting defects, deformities, and asymmetry.
Disfigured ears may be congenital or may be a result of injury, and restoring the natural appearance and contours of the ears can have a significant impact to one’s confidence and self-esteem.
Otoplasty in Vancouver, BC can be performed both on an outpatient basis or in a hospital setting, depending on the complexity of the procedure.
The procedure is commonly used to correct protruding or unusually large ears.
Am I a Candidate For Ear Surgery?
Candidates for Ear Surgery include children who are in good physical health and have ear cartilage that is stable enough for surgery. They must also be cooperative and consent to having the procedure performed.
Teenagers and adults may also be suitable candidates if they do not have existing medical conditions that may complicate recovery.
If you have any questions regarding suitability for Ear Surgery, feel free to contact us for a consultation. During your consultation, your surgeon will discuss your options for surgery and recommend a course of treatment.
Otoplasty Procedure
Ear Surgery for adults and older children can be performed under local anesthetic, however, general anesthetic may be needed for younger children.
For the procedure, a small incision is made behind the ear to expose the cartilage. Small pieces of this cartilage may be removed, repositioned, and reshaped. The newly shaped cartilage is then secured in place with stitches.
The surgery usually takes one or two hours depending on the complexity of each case. You should be able to go home the same day if local anesthetic is used.
Recovery After Ear Surgery
Bandages will need to be worn after surgery to help the ears heal. Stitches may be removed about a week after surgery. It’s important to keep the grooves behind the ears clean during the healing process.
Having sore and tender ears after surgery is normal and pain medication may be prescribed by your doctor.
Be sure to ask your surgeon if you have any questions about the recovery period.
Otoplasty Results
The results of ear surgery are immediate, and the swelling after surgery will subside as the incision heals.
It may take a few months for the final results of the surgery to appear, and it’s important to take care of the area as it heals.
As with all cosmetic surgery procedures, it may take minor adjustment surgery to achieve optimal results.
Ear Surgery Risks and Complications
It is important to weigh the risks and benefits of Ear Surgery. Your plastic surgeon will ask you sign consent forms after explaining the risks involved in the surgery.
You may experience numbness in your ears for a few weeks after surgery, this is normal. Infection is not common, but if it does occur, treatment with antibiotics may be required.
In a small number of cases, your ears may be slightly asymmetrical and may require revisional surgery.
It is important to address any concerns you may have about the procedure with your surgeon.
Cost of Ear Surgery in Vancouver, BC
The cost of ear surgery in Vancouver depends on the surgeon’s experience and location.
Ear surgery for your child may be covered by health insurance. It may not be covered for adults if it is considered cosmetic surgery. If you are unsure about your coverage, contact your insurer.
Financing plans may be available for some patients, contact us to find out if you qualify.
Frequently Asked Questions (FAQ)
1. What is the average cost of Otoplasty in Vancouver?
In Vancouver, cosmetic Otoplasty (ear pinning) typically ranges from $6,500 to $9,500 CAD. This comprehensive fee includes the FRCSC plastic surgeon’s specialized fee, operating room costs at an NHMSFAP-accredited facility, and anesthesia. Minor procedures under local anesthesia, such as earlobe repair for torn piercings or gauge reconstruction, generally range from $800 to $1,500 per ear. We provide a transparent, itemized quote during your consultation to eliminate hidden fees.
2. Is Ear Surgery covered by MSP in BC?
The Medical Services Plan (MSP) of BC generally only covers otoplasty for children under 18 if prominent ears cause documented psychological distress or bullying. For adults, altering the pinna (outer ear) is classified as elective cosmetic surgery and is never covered by MSP. For private-pay patients, our Vancouver clinic partners with reputable Canadian medical financing companies like Beautifi to offer flexible monthly payment plans.
3. What is the ideal age for a child to undergo Otoplasty?
The optimal age for pediatric otoplasty is between 5 and 7 years old. By age 5, the auricular cartilage has reached approximately 90% of its adult size and is structurally stable enough for surgical manipulation. Performing the surgery before a child enters Grade 1 in the BC school system is highly recommended to prevent psychosocial trauma and bullying related to prominent ears.
4. How is the surgery actually performed?
Prominent ears are typically caused by conchal hypertrophy (an overdeveloped cartilage bowl) or an absent antihelical fold. During surgery, the plastic surgeon makes a hidden incision in the retroauricular sulcus (the crease behind the ear). We then utilize specialized techniques like Mustarde sutures to recreate the missing fold, or cartilage scoring to reduce the conchal bowl, permanently pinning the ear closer to the mastoid bone.
5. Where will the surgical scars be located?
Otoplasty scars are virtually imperceptible. The incision is strategically placed within the natural post-auricular crease where the ear meets the head. Because the skin in this area is extremely thin and heals exceptionally well, the resulting scar fades into a fine, pale line over 6 to 12 months. Our meticulous, multi-layered plastic surgery closure ensures the scar remains hidden even if you wear your hair up.
6. Can adults get their ears pinned back?
Yes, adult otoplasty is extremely common and highly successful in our Vancouver practice. While pediatric cartilage is softer and more pliable, adult auricular cartilage is fully calcified and stiffer. This simply requires the surgeon to employ more robust cartilage scoring or excision techniques to break the “memory” of the cartilage spring. The aesthetic outcomes are just as predictable and permanent as they are for children.
7. What type of anesthesia is used for Ear Surgery?
For young children, otoplasty is performed under General Anesthesia administered by a Board-Certified Anesthesiologist (FRCPC) to ensure complete stillness and airway safety. For adults and mature teenagers, the procedure is frequently and comfortably performed under Local Anesthesia combined with oral sedation or deep IV Sedation (Twilight), allowing for a faster recovery and immediate discharge from our accredited Vancouver surgical center.
8. What is the recovery time for Otoplasty?
Most Vancouver patients return to school or desk work within 5 to 7 days. You will initially wear a bulky “helmet” dressing for 24 to 48 hours to prevent hematoma formation. Afterward, you transition to a soft athletic headband, worn 24/7 for one week, and then strictly at night for 4 to 6 weeks to protect the healing cartilage grafts and internal sutures from folding during sleep.
9. Can you fix stretched earlobes or “gauges”?
Yes. Repairing stretched earlobe gauges requires complex tissue rearrangement. Because the tissue does not shrink back naturally, the surgeon must surgically excise the excess skin and fibrous scar tissue. We then reconstruct the lobe using precise geometric flaps to recreate a natural, rounded contour. You can safely re-pierce the repaired lobe (slightly off the scar line) after 3 to 6 months of healing.
10. Will Otoplasty affect my hearing?
Otoplasty has absolutely zero impact on your hearing. The surgery strictly alters the structural cartilage and skin of the pinna (the outer ear). It does not involve or touch the external auditory canal, the tympanic membrane (eardrum), or any critical structures of the middle or inner ear. Your hearing will remain exactly as it was prior to the cosmetic procedure.
11. What is Cauliflower Ear and does Otoplasty fix it?
Cauliflower ear is a severe deformity caused by blunt trauma (like wrestling), resulting in an untreated auricular hematoma that destroys the underlying cartilage. Cosmetic otoplasty cannot simply “pin” a cauliflower ear back. It requires complex reconstructive surgery, often involving the precise excision of thickened, calcified fibrotic tissue to restore a semblance of normal anatomical contour to the ear framework.
12. Can you fix asymmetry if only one ear sticks out?
It is completely normal for ears to have slight natural asymmetries in size, shape, and protrusion. The goal of a bilateral otoplasty is to create harmonious balance, not mathematically identical mirror images. If you suffer from unilateral prominence (only one ear sticks out), we still frequently operate on both ears to ensure optimal symmetry and proportional set-back against your specific facial structure.
13. Will my ears “pop back” out after surgery?
When performed by an FRCSC plastic surgeon utilizing permanent internal sutures (like Nylon or Prolene) and proper cartilage scoring, the results of an otoplasty are permanent. While a tiny degree of relaxation (1-2 millimeters) is biologically normal as swelling subsides over the first few months, the ear will not recur to its pre-operative prominent state unless severe trauma breaks the internal sutures.
14. Can I wear glasses or sunglasses after surgery?
You must avoid resting prescription glasses or heavy sunglasses directly on the surgical site for 2 to 3 weeks post-surgery. The physical pressure from the arms of the glasses can severely irritate the healing retroauricular incision, increase swelling, and potentially alter the setting of the cartilage. Vancouver patients are advised to gently tape their glasses to their temples or use contact lenses during the initial healing phase.
15. When can I return to sports like hockey or rugby?
Light walking on the Vancouver Seawall is encouraged immediately to promote circulation. However, strenuous cardiovascular exercise is banned for 3 to 4 weeks to prevent late bleeding. Contact sports involving a high risk of ear trauma (such as hockey, martial arts, or rugby) must be strictly avoided for a minimum of 6 to 8 weeks until the newly sculpted cartilage has achieved maximum tensile strength.
16. Is there an “incisionless” Otoplasty option?
While “incisionless” techniques (using only sutures passed blind through the skin) or the Earfold™ implant exist, they carry a significantly higher rate of recurrence and implant extrusion. For the vast majority of Vancouver patients with thick cartilage or severe conchal hypertrophy, the traditional “open” surgical approach provides vastly superior, highly customizable, and permanent structural results that minimally invasive shortcuts simply cannot match.
17. Can you fix a torn earlobe from heavy earrings?
A cleft earlobe—caused by heavy earrings tearing through the tissue or accidental snagging—is a very common repair in our clinic. This is a straightforward 30-minute procedure performed under local anesthesia. We excise the epithelialized (healed) edges of the tear and meticulously suture the fresh tissue back together in layers, ensuring a smooth, continuous margin free from “step-off” deformities.
18. What are the medical risks of Otoplasty?
While highly safe, otoplasty carries specific surgical risks. The most critical is a hematoma (blood collecting under the skin), which requires immediate drainage to prevent cartilage death (necrosis). Other risks include infection (chondritis), unfavorable scarring (keloids), suture extrusion (a stitch poking through the skin), and minor asymmetry. Operating in an NHMSFAP-accredited facility with strict blood pressure control dramatically mitigates these risks.
19. How do I prepare for Ear Surgery?
To ensure optimal healing and prevent tissue necrosis, you must stop smoking or vaping nicotine for at least 4 weeks before and after surgery. Additionally, discontinue all blood-thinning supplements (Aspirin, Advil, Omega-3s, Vitamin E) two weeks prior to minimize intraoperative bleeding. We advise Vancouver patients to purchase soft, button-down shirts so they do not have to pull tight clothing over their healing ears.
20. Am I at risk for Keloid scars on my ears?
Patients with darker skin tones or a genetic predisposition have a higher risk of developing keloids (thick, raised, itchy scars) along the incision behind the ear. During your consultation, an FRCSC plastic surgeon will carefully assess your skin type. If you are high-risk, we employ prophylactic measures such as specialized tension-free closure, post-operative silicone sheeting, or localized steroid (Kenalog) injections to suppress aggressive scar formation.
Book a Consultation Today
Service Area Locations
Dr Anzarut Plastic Surgery in Vancouver serves Kitsilano, Burnaby, Coquitlam, New Westminster, Richmond, Surrey, Delta, North Vancouver, West Vancouver, Langley, and White Rock in Metro Vancouver (Lower Mainland), British Columbia.
Dr Anzarut Plastic Surgery in Duncan serves Victoria, Nanaimo, Courtenay, Campbell River, Parksville, Port Alberni, Ladysmith, Cowichan Valley, and Comox Valley on Vancouver Island.
Things to Consider When Choosing Ear Surgery (Otoplasty) in Vancouver
Whether addressing prominent ears to prevent childhood bullying or seeking adult earlobe reconstruction, otoplasty is a procedure of millimeters. Altering the intricate folds of auricular cartilage requires structural precision to avoid the dreaded “pinned-back” look. This comprehensive checklist covers every clinical, anatomical, financial, and logistical detail you must know before booking ear surgery in Vancouver, BC or any specialized clinic in British Columbia.
I. Surgeon & Facility Credentials (The “Who” and “Where”)
- FRCSC Certification: Verify your surgeon is a Fellow of the Royal College of Physicians and Surgeons of Canada in Plastic Surgery.
- Pediatric Comfort Level: If the patient is a child, ensure the surgeon has extensive experience with pediatric auricular cartilage, which behaves differently than adult cartilage.
- NHMSFAP Accreditation: Your surgery must occur in a private facility fully accredited by the Non-Hospital Medical and Surgical Facilities Accreditation Program (NHMSFAP) of BC.
- CPSBC Standing: Search the College of Physicians and Surgeons of BC directory to confirm your surgeon has a clean disciplinary record.
- Hospital Privileges: A top-tier Vancouver surgeon will hold admitting privileges at major local hospitals, such as BC Children’s Hospital or Vancouver General Hospital (VGH).
- Anesthesia Provider: Ensure any IV sedation or general anesthesia is administered by an FRCPC Board-Certified Anesthesiologist.
- Specialist Focus: Practices like Dr. Anzarut Plastic Surgery focus heavily on complex facial and auricular aesthetics, ensuring deep anatomical familiarity.
- Before & After Consistency: Look specifically for the helical rim in gallery photos from the front view. If the rim is invisible, the ears are over-corrected (“telephone ear” deformity).
- Malpractice Insurance: Verify the surgeon carries robust coverage through the Canadian Medical Protective Association (CMPA).
- Revision Experience: Surgeons who routinely perform revision otoplasty possess a vastly superior understanding of underlying cartilage failure points.
II. Anatomy & Physiology of the Ear
- The Pinna (Auricle): The external, visible part of the ear composed of elastic cartilage and thin skin.
- Conchal Hypertrophy: An overdeveloped, deep cartilage “bowl” (concha) that physically pushes the ear away from the side of the head.
- Antihelical Fold Absence: The lack of the natural Y-shaped fold in the upper ear, causing the top half of the ear to stick straight out.
- Prominent Lobule: When the earlobe itself sticks out, even if the upper cartilage is normal. Requires specific soft-tissue setback techniques.
- Cartilage Memory: Ear cartilage naturally wants to spring back to its original shape. Surgery must overcome this “memory” to be permanent.
- Calcification: Adult cartilage is stiffer and partially calcified compared to a child’s pliable cartilage, requiring more aggressive surgical scoring.
- Asymmetry: No two ears are perfectly identical. Surgery improves symmetry but mathematical perfection is biologically impossible.
- Stahl’s Ear: A deformity characterized by an extra horizontal cartilage fold, giving a “Spock-like” pointed appearance.
- Constricted (Lop) Ear: The top rim of the ear is folded over or wrinkled. Requires complex cartilage grafting to expand the rim.
- Microtia: A severe congenital deformity where the external ear is underdeveloped. Requires multi-stage rib cartilage reconstruction, not standard otoplasty.
III. Surgical Techniques & Approaches
- Retroauricular Incision: The gold standard approach. A hidden incision placed in the post-auricular sulcus (the crease behind the ear).
- Mustardé Sutures: Permanent internal sutures used to bend the cartilage and recreate a missing antihelical fold.
- Furnas Sutures: Deep internal sutures that anchor the conchal bowl directly to the mastoid fascia (the tissue over the skull) to pull the whole ear inward.
- Cartilage Scoring: Carefully scratching the front surface of the cartilage to weaken its spring, forcing it to bend backward permanently.
- Conchal Excision: Removing a small crescent of cartilage from the conchal bowl if it is too deep to simply pin back.
- Fascial Flaps: Using a layer of soft tissue behind the ear to cover the permanent sutures, preventing them from extruding (poking out) later.
- Incisionless Otoplasty: Passing sutures blindly through the skin. Carries a high relapse rate and is generally avoided by top FRCSC surgeons.
- Earfold™ Implant: A small metal clip inserted to fold the ear. While fast, the rigid implant can sometimes be felt or seen under thin ear skin.
- Suture Material: Surgeons use non-absorbable (permanent) sutures like Prolene or Nylon internally to ensure the ear holds its new shape for life.
- Tension-Free Skin Closure: The internal sutures bear all the tension. The skin behind the ear is closed loosely to ensure a hair-thin, invisible scar.
IV. Financials & BC Medical Services Plan (MSP)
- MSP Coverage (Pediatric): The Medical Services Plan (MSP) typically covers otoplasty for children (usually under 18) if prominent ears cause documented psychological distress.
- MSP Non-Coverage (Adults): For adults, otoplasty is classified as cosmetic and is never covered by MSP.
- Adult Private Cost Range: In Vancouver, bilateral adult cosmetic otoplasty typically ranges from $6,500 to $9,500 CAD.
- Earlobe Repair Cost: Minor repairs (torn lobes, gauge closure) are performed under local anesthesia and range from $800 to $1,500 per ear.
- 5% GST: Elective cosmetic surgery for adults is subject to the 5% Goods and Services Tax (GST) in Canada.
- Medical Financing: Many Lower Mainland clinics partner with Beautifi or Medicard to offer flexible monthly payment plans.
- Quote Transparency: Ensure your itemized quote explicitly includes the surgeon’s fee, OR facility time, anesthesia, and the post-op headband.
- Consultation Fees: Expect a $100-$250 initial consult fee, which is usually applied toward your surgical total.
- Non-Refundable Deposits: Securing OR time typically requires a deposit ranging from $500 to $1,500.
- Tax Deductibility: Purely cosmetic otoplasty is generally not a tax-deductible medical expense by the CRA.
V. Pediatric vs. Adult Considerations
- The Age 5 Rule: Auricular cartilage reaches 85-90% of adult size by age 5. This is the earliest safe age to perform otoplasty without stunting ear growth.
- Psychosocial Timing: Performing surgery before a child enters Grade 1 or 2 is optimal to prevent bullying and self-esteem damage.
- Child’s Motivation: The child must understand and want the surgery. If forced by parents, they will likely refuse to wear the necessary post-op headbands.
- School Timing: Vancouver parents typically book pediatric otoplasty during Spring Break or summer vacation to allow discreet healing.
- Adult Touch-Ups: Adults who had otoplasty as children sometimes seek a minor revision later in life due to slight cartilage relaxation over decades.
- Hearing Unaffected: The surgery only alters the outer cartilage. It has zero impact on the external auditory canal or the middle/inner ear.
- Cartilage Stiffness: Adult surgery takes slightly longer because the calcified cartilage resists folding and requires more meticulous scoring.
- General Anesthesia (Kids): Children almost always require general anesthesia for safety and stillness.
- Local Anesthesia (Adults): Adults can often undergo the procedure under local anesthesia (awake but completely numb) to save on costs and recovery time.
- Growth Spurts: Cranial vault growth will not pull the ears back out once the cartilage has healed in its new position.
VI. Pre-Operative Preparation
- Nicotine Ban: You must stop smoking/vaping 4 weeks pre-op to prevent tissue necrosis (skin death) and severe infection of the ear cartilage.
- Blood Thinners: Discontinue Aspirin, Advil, Vitamin E, Fish Oil, and Ginseng two weeks prior to minimize surgical bleeding and hematoma risks.
- LifeLabs Bloodwork: You will likely need pre-op blood tests if undergoing general anesthesia.
- Wardrobe Prep: Buy button-down or zip-up shirts. You cannot pull tight sweaters over your head or your post-op head dressing.
- Headband Purchase: Buy 2-3 soft, elastic athletic headbands (tennis style). You will need these for recovery once the initial bandages come off.
- Post-Op Escort: You cannot take an Uber or BC Transit alone after sedation. A responsible adult must drive you home.
- Pillow Setup: Purchase a travel neck pillow (U-shaped). It helps keep pressure off the ears while sleeping on your back.
- Hair Colouring: Dye your hair before surgery; you will not be able to apply chemicals near the healing incisions for 4 weeks post-op.
- Hygiene: You will wash your hair with an antibacterial soap (like Hibiclens) the morning of surgery.
- Fasting: Strict NPO (nothing by mouth) after midnight the night before your surgery if undergoing IV sedation or general anesthesia.
VII. The Surgical Experience & Immediate Recovery
- Duration: A bilateral otoplasty typically takes 1.5 to 2.5 hours.
- Tumescent Numbing: The surgeon injects a mixture of saline, lidocaine, and epinephrine to numb the ear, shrink blood vessels, and hydro-dissect the skin off the cartilage.
- The “Helmet” Dressing: You will wake up with a bulky, snug turban-like bandage wrapped around your head to apply pressure and prevent blood pooling.
- Discharge: Otoplasty is an outpatient day surgery; you will go home the same afternoon.
- Strict Elevation: Keep your head elevated above your heart to minimize severe throbbing and swelling.
- Bandage Removal: The bulky “helmet” is typically removed in the clinic within 24 to 48 hours.
- The Reveal: Your ears will look swollen, bruised, and slightly over-pinned initially. This is completely normal.
- Headband 24/7: Once the bandages are off, you must wear a soft athletic headband 24 hours a day for the first week.
- Nightly Headband: After week one, you must wear the headband strictly at night for 4 to 6 weeks to prevent the ear from folding forward while you sleep.
- Pain Control: Patients describe the pain as a severe, tight throbbing, usually manageable with Tylenol after the first 48 hours of prescribed analgesics.
VIII. Long-Term Healing & Logistics in Vancouver
- Showering: You can usually shower and gently wash your hair with baby shampoo after the heavy bandages are removed (48 hours).
- Incision Care: Keep the area behind the ear clean and dry. Apply prescribed antibiotic ointment if directed by your surgeon.
- Suture Removal: If non-dissolving sutures are used on the skin, they are removed in the clinic around Day 7 to 10.
- Glasses Ban: You cannot rest heavy prescription glasses or sunglasses directly on the healing ears for 2-3 weeks. Tape them to your temples.
- Numbness: The ears will feel completely numb and “wooden” for several months. Sensations return slowly with itchy, electrical “zingers.”
- Exercise Return: Light walking on the Vancouver Seawall is mandatory immediately. Heavy lifting and vigorous cardio are banned for 3 to 4 weeks.
- Contact Sports: Hockey, rugby, and martial arts must be strictly avoided for 6 to 8 weeks until the cartilage achieves maximum tensile strength.
- UV Protection: Vancouver sun can permanently darken fresh scars (hyperpigmentation). Apply SPF to the ears once fully healed.
- Weather Protection: Cold Vancouver wind hurts numb ears. Wear a loose toque over your headband in the winter.
- Final Contour: The swelling fully resolves, and the ears settle into their final, natural position within 3 to 6 months.
IX. Risks & Complications (The “What Ifs”)
- Auricular Hematoma: The #1 surgical risk. A rapid pooling of blood under the skin causing intense, one-sided pain. Requires immediate drainage to prevent “cauliflower ear.”
- Chondritis: A serious infection of the ear cartilage. Causes heat, extreme redness, and pain. Requires immediate antibiotics.
- Suture Extrusion: A permanent internal stitch poking through the thin skin behind the ear months later. Easily removed in the office.
- Over-Correction (Telephone Ear): The middle of the ear is pinned too tight, making the top and bottom stick out.
- Under-Correction (Relapse): The ear springs back slightly. A 5-10% relapse rate exists globally; may require a minor revision.
- Keloid Scars: Severe, overgrown, itchy scars behind the ear. High risk for patients with darker skin tones. Treatable with Kenalog (steroid) injections.
- Skin Necrosis: Death of the skin due to overly tight bandages or smoking. Heals slowly and may leave a scar.
- Hyperesthesia: Chronic sensitivity to cold temperatures long after the surgery has healed.
- Asymmetry: Minor differences in ear set-back distances (e.g., 15mm vs 17mm) are normal.
- Dissatisfaction: Usually stems from unrealistic expectations of mathematical perfection.
X. Earlobe Revisions & Additional Procedures
- Split Earlobe Repair: A 30-minute local anesthesia procedure to excise and suture a lobe torn by heavy earrings or trauma.
- Gauge Reconstruction: Closing large, stretched earlobe holes requires complex geometric tissue flaps, not just simple suturing.
- Re-Piercing Timeline: You must wait a minimum of 3 to 6 months before re-piercing a repaired earlobe.
- Piercing Placement: Never re-pierce directly into the scar line; the scar tissue is weak and will tear easily. Pierce slightly off-center.
- Earlobe Reduction: As we age, earlobes continue to grow and sag. Earlobe reduction surgically trims the excess tissue for a youthful proportion.
- Keloid Excision: Removing keloids caused by piercings requires surgical excision often followed by specialized pressure earrings or radiation to prevent recurrence.
- Flying Restrictions (YVR): You should avoid flying for at least 1 week post-op due to pressure changes and the inability to manage a hematoma at altitude.
- Avoid Medical Tourism: Traveling abroad for otoplasty leaves you stranded if a cartilage infection or hematoma occurs back in BC.
- Second Opinions: Consult with at least two FRCSC plastic surgeons in the Lower Mainland to ensure you are comfortable with their specific cartilage techniques.
- The Psychological Payoff: The recovery is slightly restrictive, but the ultimate reward is profound, lifelong confidence, allowing you to finally wear your hair up without a second thought.
