In today’s culture, appearance is very important. From a leaner waistline, to a smoother complexion, there are many surgical options and cosmetic procedures available to make a person look, feel, and live better. One area that is an issue for many people is protruding ears, otherwise known as “bat ears”. Ears that stick out can be quite obvious and can severely affect the self-esteem and appearance of those that suffer from them.
Content Reviewed by AEDIT Medical Advisory Board
Protruding ears can appear due to a medical issue or from an inherited genetic background, and often creates concerns for people from an aesthetic and cosmetic standpoint. Although ears that stick out don’t usually cause adverse physical health problems, the mental and emotional stress from this condition can far outweigh any physical concerns, especially for younger patients and teenagers.
This article provides an in-depth review of the medical and cosmetic concerns of protruding ears, and when an ear meets the qualifications for a cosmetic surgical intervention. We will also cover the methods of cosmetic surgical procedures for correction, the impact of protruding ears in popular culture, some common but dangerous remedies to avoid, and some tips to follow before proceeding with a plan to correct a protruding ear.
Easily recognizable by sight, protruding ears stand out from normally positioned ears, which lie flat against the skull, and can be very noticeable in babies, children, and adults. Although protruding ears are quite common, the trait itself is considered aesthetically undesirable and can cause severe psychological distress, bullying, and other negative consequences for those that have them.
From a medical standpoint, protruding ears are harmless and unlikely to cause physical distress, pain, hearing loss, or other medical issues, and is a purely cosmetic problem. Even so, protruding ears are considered to be one of the most common congenital deformities of the head and neck area affecting young people, and are usually apparent at birth.
Those that suffer from this condition are likely to develop poor self-esteem and low confidence, emotional pain, and other negative symptoms. Fortunately, cosmetic procedures are available that can help to improve the appearance of protruding ears, and that can eliminate the pain and suffering that individuals may experience as a result of this condition.
What constitutes a “bat ear” and separates it from a normally positioned ear can be tricky, and there is no official consensus as to what the definition of a protruding ear and its characteristics should be. This means that surgeons are responsible for evaluating each patient on an individual basis and using his or her professional expertise and judgment to determine what is considered a normal ear fold and a “prominent” one. A prominent ear can depend on a wide variety of factors including the specific measurement of the cartilage behind the ear (the antihelical ear fold), the measurements from the upper and lower ear flaps to the skull, the surgeon’s opinion about the patient’s protrusion measurements, and the patient’s feelings about their appearance.
Another important factor that some doctors may consider when evaluating a patient’s protruding ears is gender. Most experts agree that the measurements that would qualify a case of excessive ear protrusion differ greatly between the sexes. In several studies, the ear measurements of both males and females were found to be different. In males, the protrusion can be considered prominent when the distance between the upper ear and the skull exceeds 21-21.5 mm., or the lower protrusion measurement exceeds 20.0 mm. However, in females, the range can be smaller. Prominent protrusion is measured by exceeding 17.5 mm for the upper ear or the lower protrusion exceeds 15.5 mm.
For older children and adults whose ears are considered as excessively protruding, cosmetic intervention is the only verified treatment that can be relied upon for adequate correction. In particular, two procedures are currently recommended for fixing protruding “bat” ears: otoplasty, and Earfold® surgery.
The ear is a delicate part of the body. Multiple parts make up the ear both externally and internally, including the antihelical fold, also known as the “conchal bowl”, which refers to the cartilage of the ear that connects the ear to the skull. Due to the delicate nature of this skin, especially in newborns and infants, the method of correction should be delicate in regards to handling both soft and hardened cartilage. In particular, the soft, malleable cartilage of infants that have not yet molded or hardened into a permanent shape it will take on into adulthood, is particularly responsive to molding and re-shaping techniques.
Many infants can benefit from non-surgical methods of correction within the first few months after birth. Beyond a certain point, however, the cartilage of a child’s ear begins to harden, and it becomes more complicated to resolve with non-surgical methods and will more likely require surgical correction such as:
Otoplasty: This procedure is also known as ear pinning. With this procedure, the protruding ears are permanently moved closer to the side of the head. Besides being moved closer, this surgery can also reduce the size of the ear along with correcting the angle of the ear’s protrusion. The procedure is very popular and common for all ages from small children to adults.
Earfold®: This relatively new procedure is an alternative to an otoplasty procedure. Designed to be minimally invasive, this procedure involves inserting a small implant made of nitinol (nickel-titanium alloy) to correct the protruding ear. Once inserted, the implant works to bend the ear to the patient’s desired angle. All of this is done without cutting into or removing the cartilage.
In children and babies, significant results can be achieved by applying an ear splint to position the undeveloped antihelical fold into place as the cartilage forms. This method is only effective in a very young child’s ear, and most successful when applied to infants whose cartilage is still soft, pliable, and moldable. This method is not effective for older children and adults, as the cartilage has already hardened.
It should be noted that there no approved DIY treatments or home remedies for improving the appearance of bat ears without the professional assistance of a board-certified plastic surgeon. However, because ear protrusion is such a common problem, some unverified and dangerous methods have been relatively widespread that claim to fix “bat ears” at home and without medical assistance.
In particular, a dangerous and ineffective solution is using ear glue to glue the ears into place. While not always risky, this method has been known to be inefficient and can sometimes lead to dangerous results. In one particular case, surgeons were able to effectively treat a boy who applied superglue to the skin behind the ears. The continued and repeated use of the glue on the skin resulted in severely irritated skin. While several brands of ear glue exist to glue ears to the skull, the results are not usually considered ideal and applications, even if safe on the skin, are temporary and difficult to keep up.
Another solution that can be very dangerous is pinning the ears to the skull with a sewing needle and thread. This method, which has unfortunately been used for centuries, is painful and carries a high risk of infection. It can also result in a severe ear deformity of the external ear, or even affect the internal ear area.
Protruding ears have played a large role in pop culture. From the MAD magazine kid to cartoons, you don’t have to look far to see examples of protruding ears in the media. Celebrities are no different in this matter. Some of the most popular and attractive celebrities have protruding ears or have had them corrected. Some of the most famous cases of celebrities with protruding ears include former president Barack Obama, Will Smith, Stephen Colbert, Kate Hudson, Jennifer Garner, and Emma Watson. Celebrities who are rumored to have had surgery to correct protruding ears include actors Ben Stiller and Brad Pitt.
Pop culture shows us that for many people, unique qualities like protruding ears, a large nose, or a large rear end can be boons that help celebrities and other people stand out from the crowd in a positive way. Many people can embrace “defective” or undesirable qualities and turn them into positive features, while others simply prefer to change them with plastic surgery. The decision to alter your appearance is a personal choice that should be taken seriously, and your doctor can help you evaluate the options you have to make the choice that’s best for you.
Before your consultation, take note of the following questions to ask your doctor when visiting a surgeon about solutions for protruding ears:
In addition to those questions, be sure to address any other concerns you may have about your surgery, and to share your complete medical history and records with your doctor. Finally, make sure that your physician is a board-certified plastic surgeon and has plenty of experience performing the procedure you’d like to have.
