The Cadogan Clinic in Chelsea, London is the primary UK centre for bespoke cauliflower ear treatment. 100% of Cadogan Clinic’s surgical patients would recommend the Clinic to their family and friends.

What is Cauliflower Ear?

Cauliflower ear, also known as auricular hematoma or perichondrial hematoma, is a deformity of the outer ear, resulting in a thick and irregular appearance to the upper part of the ear.

Cadogan Clinic’s centre of surgical excellence, based in Chelsea, London, is home to the UK's best Consultant Plastic Surgeons. The Clinic is the primary UK centre for bespoke cauliflower ear treatment, providing the highest standards of patient care and outcomes, maintaining an industry-leading 0.01% infection rate and 0.8% revision rate across all surgical procedures, significantly lower than the UK national averages.

Generally caused by damage to the cartilage and blood vessels in the outer ear due to blunt force, cauliflower ear can have a range of functional and aesthetic impacts not only on the ear but also on the overall head area:

• Asymmetry and cosmetic concerns: Cauliflower ear causes an atypical appearance in the ear(s), varying in severity
• Infections: In some cases, having a cauliflower ear may increase the risk of infections developing
• Hearing loss: Severe swelling and structural impairment can lead to temporary or long-term hearing loss
• Loss of confidence: Both functional and cosmetic concerns arising from cauliflower ear can cause increased self-consciousness and feelings of isolation, affecting personal and professional life

Many people affected by cauliflower ear find that their comfort, confidence and quality of life are significantly impacted. Although at first glance it is purely a cosmetic condition, it can have serious, sometimes long-term implications for health and well-being.

In 2024, the British Association of Aesthetic Plastic Surgeons reported that Ear Reshaping procedures were the tenth most popular surgical procedure overall, but the fourth most popular among men, with a 14% increase on the previous year.

Cauliflower ear is a condition caused by damage to blood vessels and cartilage, resulting in a deformity of the outer ear, leading to a wide range of functional and aesthetic concerns.

What are the Symptoms of Cauliflower Ear?

Although the visible ear deformity is the primary symptom of cauliflower ear, there are other signs to be aware of that may develop at the different stages of cauliflower ear.

Early symptoms of cauliflower ear that may arise during the first two stages include:

• Redness
• Swelling
• Bruising
• Bleeding
• Pain
• Warmth
• Tightness or pressure

Cauliflower ear symptoms that typically develop during the later stages include:

• Changes in ear shape, in particular, a puffed up ear
• Ear position changing, in some cases, becoming more protruding
• Skin becoming pale due to the disrupted blood supply
• Abnormal texture in the upper ear
• Firm scar tissue developing

Most cauliflower ear symptoms are aesthetic. However, there are serious functional complications which can occur, that it is important to be aware of:

• Infections: The blood trapped between the cartilage and skin can lead to infection, known as perichondritis, which can cause further damage to the cartilage and structure of the outer ear
• Hearing Loss: Swelling and misshapen cartilage can block the ear canal, causing hearing loss. In severe cases, this may be permanent
• Tinnitus: Severe changes to the cartilage may lead to ringing in the ears, known as tinnitus

In most cases, severe complications of cauliflower ear can be limited or prevented through swift management and treatment. Cadogan Clinic’s expert Consultant Plastic Surgeons operate within a leadership team rated Outstanding by the Care Quality Commission (CQC), ensuring you receive the highest-quality cauliflower ear treatment in the required timeframe.

Cauliflower ear symptoms can vary widely and include a lumpy, abnormal outer ear appearance, redness, swelling, tightness, and, in severe cases, hearing loss, infections, and tinnitus.

What Causes Cauliflower Ear?

Generally speaking, cauliflower ear is caused by injury to the cartilage and blood vessels within the ear, resulting in separation of the skin from the cartilage, allowing a hematoma to form.

However, there are several reasons this can occur, and causes of cauliflower ear can include:

Contact Sports

The most common cause of cauliflower ears, the nature of contact sports means that there is a high risk of blood vessel injury. Cauliflower ears are often seen in those who participate in:

• Rugby
• Boxing
• Martial Arts

Although other contact sports may result in cauliflower ears, these are the most common, as they involve close contact, grappling, and frequent head impacts, which can lead to damage to the blood vessels in the ears.

Among individuals who participate in contact sports, it has been shown that there are several factors which increase the frequency of cauliflower ears:

• Higher Level Competition: Typically due to the higher intensity of semi-professional and professional competition. One Finnish study found that 96% of athletes competing at the national level in martial arts experienced at least one sign of cauliflower ear
• Age: Older sportspeople who continue to participate in contact sports are more likely to develop cauliflower ear; however, it is not understood whether this is due to physiological changes or simply increased exposure and chance of injury over time
• Gender: Various studies have shown that men are more likely to experience cauliflower ear, although there could be various societal reasons for this, including being less likely to use head protection

Anyone who participates in contact sports should be aware of the risk of cauliflower ear and ensure they wear appropriate head protection to prevent it from occurring.

Piercings

In some cases, piercings in the cartilage of the upper section of the ear may lead to cauliflower ear.

Piercings that go through the cartilage are more likely to damage the blood vessels and the surrounding tissue, disrupting the blood flow to the cartilage, and increasing the risk of cauliflower ear occurring.

Additionally, infections are more common in cartilage piercings, increasing the likelihood of cauliflower ear and making treatment more challenging.

Various risk factors are associated with cauliflower ear developing after a cartilage piercing:

• Inexperienced Practitioner: A piercing practitioner who is not sufficiently qualified or experienced is more likely to cause damage when performing a cartilage piercing
• Poor Placement: Placing a cartilage piercing in an area with a high density of blood vessels is more likely to result in complications
• Allergies: In rare cases, allergic reactions to the jewellery placed in the piercing may cause sufficient inflammation to damage the blood vessels and cause a cauliflower ear

Ensuring you see a qualified, experienced piercing practitioner for any ear piercings is essential to prevent potentially permanent damage.

Accidental Injury

In some severe cases, accidental injuries, such as falls or significant impacts to the outer ear, may lead to cauliflower ear.

Any impact to the outer ear that is forceful enough to damage the blood vessels in the ear may lead to the development of cauliflower ear. However, it is important to acknowledge that these types of injuries are rare for the majority of people.

Individuals who experience an accident which results in the signs of a head injury may find that they are assessed for cauliflower ear, depending on the area of their head that was directly affected.

Regular participation in contact sports is the most common cause of cauliflower ear, however, other causes can include cartilage piercings and accidents resulting in direct impact to the outer ear.

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