What are Protruding Ears?

Protruding ears, also known as prominent ears, or medically otapostasis, describes ears that stand away from the head in a disproportionate way.

Ears which protrude more than 2cm from the head are considered to be more prominent than average. One (unilateral) or both (bilateral) ears can be affected.

Both men and women are affected by protruding ears, and it is a common concern that leads an increasing number of people to seek treatment.

Between 2023 and 2024, the British Association of Aesthetic Plastic Surgeons (BAAPS) recorded:

• An overall 2% increase in the number of Ear Correction surgeries performed
• But a significant increase of 14% in the number of male patients undergoing Ear Correction procedures

Having protruding ears can significantly affect an individual’s confidence, increasing self-consciousness and influencing how they present themselves and wear their hair.

Treating protruding or prominent ears can have a dramatic, positive impact on confidence and quality of life for individuals who are affected by this concern. Speaking with a qualified and experienced Consultant Plastic Surgeon is the best way to develop and undertake an effective treatment plan.

Are Protruding Ears Attractive?

When discussing any variable physical features, it is important to remember that everyone’s individual facial proportions are unique, and what naturally suits one person may not suit another.

The natural shape and size of the ears can significantly affect an individual’s overall appearance. As the placement of the ears means they are often noticeable, especially on those with shorter hair, a prominent ear position can greatly influence facial appearance.

Although the medical definition of protruding ears is based on a measurement of 2cm or more, for some people’s facial proportions, less than 2cm may have a marked impact on their appearance.

Whether protruding ears are considered attractive is purely subjective, though individual facial proportions and balance will play an important role.

What are the Symptoms of Protruding Ears?

The signs and symptoms of protruding ears are primarily physical, though there are mental and psychological effects that can profoundly impact an individual’s well-being and quality of life.

Physical Symptoms of Protruding Ears

• Ears which protrude 2cm or more from the sides of the head
• High visibility of the ears when the face is viewed front on
• Underdeveloped antihelix and scapha
• Large and deep concha

Psychological Side Effects of Protruding Ears

• Low confidence and increasing self-consciousness
• Anxiety, which may develop into body dysmorphia affecting other areas
• Feeling preoccupied about the visibility of the ears, and hiding them using hairstyles or clothing which covers the head
• Apprehension in social and professional settings

The severity of protruding ear signs and symptoms may vary from person to person, and some patients may even find that their ears are affected to differing extents.

What Causes Protruding Ears?

Protruding ears are usually apparent from birth or very early childhood. There are several reasons why protruding ears develop:

Genetics

In most cases, protruding ears are caused by genetics. You are more likely to have prominent ears if members of your direct family also have the same trait. However, it is also possible for someone without family members with protruding ears to be born with them.

Although multiple family members may all have protruding ears, the severity may vary.

It isn’t possible to know whether your child(ren) will have protruding ears before they are born.

Foetal Development

The physical traits which are associated with protruding ears typically develop in the womb. However, they may not be apparent until early childhood, once the ears have grown further.

Protruding ears typically occur because of the over or under development of certain parts of the ear cartilage.

• Overdeveloped Concha – The concha is the bowl-shaped part of the ear which pushes the ear away from the head. When there is too much cartilage in the concha, the ears may be pushed further forward.
• Underdeveloped Antihelix – The antihelix is the fold of cartilage which partially surrounds the concha. When this doesn’t fully develop, the ears may protrude further from the sides of the head.

The best way to establish your exact prominent ear causes is to speak with a Consultant Plastic Surgeon who can discuss your concerns and assess your ear cartilage to find the best treatment for your needs.

How to Fix Protruding Ears?

The best treatment for protruding or prominent ears depends on a patient’s personal concerns and their desired results.

Surgery for Protruding Ears

Pinnaplasty

Pinnaplasty, also known as Ear Pinning, is a surgical procedure which reshapes the ear cartilage, allowing the ears to be repositioned to be flatter against the head.

Pinnaplasty is a type of Otoplasty surgery. Otoplasty is a generic term for Ear Correction and Reshaping procedures that can address other concerns besides protruding ears.

During a Pinnaplasty:

• An incision is made behind the ear
• Excess skin and cartilage are removed from the back of the ear
• The concha is secured to the bony area of the head, next to the ear (the mastoid), using sutures
• The incision is closed

Pinnaplasty can be performed under local or general anaesthetic and usually takes less than 2 hours to complete.

Recovery after a Pinnaplasty is usually straightforward and takes 4-6 weeks.

Your surgeon will show you a selection of Pinnaplasty before and after images to help you understand the results that are possible when treating your personal concerns.

At What Age Can You Get Your Ears Pinned Back?

In the UK, the minimum age for Pinnaplasty depends on why the surgery is being performed.

For all procedures, the legal age for cosmetic surgery is 18. It is illegal for any surgeon to perform a Pinnaplasty for purely aesthetic reasons on a patient under this age. However, there may be specific individual circumstances in which it is deemed appropriate and beneficial to undergo Pinnaplasty at a younger age.

The main factors which influence the best age for Ear Pinning are:

Can You Fix Protruding Ears Without Surgery?

There are various methods on the market which claim they can correct protruding ears without surgery, including:

• Headbands
• Surgical tape
• Clips

Although these options may provide temporary changes or disguise the projection of the ears, they do not offer a long-term or permanent solution and may be uncomfortable. Once the outer ear is fully developed (by around 9 years old), it isn’t possible to permanently alter the contours of the ear cartilage without surgical intervention.

Cadogan Clinic’s expert surgeons recommend surgical Ear Correction procedures for optimal, long-lasting correction of prominent ears.

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