Protruding ears are common, hereditary, and entirely a matter of cartilage shape. In most cases the fold that normally creases the outer ear never fully formed, or the bowl of the ear is deep, so the ear stands away from the head. It affects hearing not at all and self-consciousness a great deal, from childhood teasing to adults who have grown their hair over their ears for decades.
Otoplasty, ear pinning, corrects it in one procedure with a result that lasts a lifetime. It is one of the most straightforward operations in plastic surgery, and one of the most gratifying.
What the surgery does
Through an incision hidden in the crease behind the ear, the surgeon reshapes the cartilage, creating or deepening the fold and reducing the depth of the bowl, then sets the ear closer to the head with permanent sutures. Both ears are usually done together for symmetry even when one protrudes more. The operation takes about two hours, under local anesthesia with sedation for adults and general anesthesia for children.
The result is an ear that looks like it always sat that way, with the natural folds present and the scar invisible behind it. Over-correction, ears pinned flat against the head, is the mark of poor technique; a good result leaves the ear at a normal angle.
Children and adults
Ear cartilage reaches most of its adult size by about five or six, which is why surgery is offered from that age and often chosen before school, when teasing tends to begin. Cartilage in children is softer and reshapes easily. Adults have the same operation with the same result; there is no age at which it stops working, and many adults who have it describe it as the easiest decision they ever put off.
Recovery
A padded headband covers the ears for about a week to protect them and hold the new position, then a lighter band is worn at night for several weeks. Soreness and some bruising are normal; significant pain is not. Children return to school in about a week, adults to desk work in a few days, and contact sports wait a couple of months. The ears look settled within weeks and fully refined within a few months.
Cost
Otoplasty for both ears typically costs several thousand dollars, varying with the surgeon and city, and is generally not covered by insurance when the reason is appearance. Some plans cover it for children in specific circumstances; the surgeon’s office can advise.
How to choose a provider
Ask how many otoplasties the surgeon performs and to see results from the front and the side, at six months, including on children if that is who the surgery is for. Ask how they avoid over-correction and what their touch-up rate is. Ask about anesthesia for a child. An experienced surgeon will explain the specific cartilage problem in your ears and the technique they will use for it.
Browse the surgeons below. A photo from behind, showing both ears, is the most useful one for the consultation.