Prominent ears or otapostasis, are ears that protrude from one’s head more than they usually would. This usually occurs from childhood and although protruding ears do not affect one’s hearing, this condition can take a toll on one’s self-esteem and cause psychological distress. Thankfully, this can be resolved with prominent ear correction, also known as otoplasty surgery.
They may appear unilateral or bilateral, where the concha is large with a poorly developed antihelix and scapha. Stemming from the malformation of cartilage during primitive ear development, this stage in intrauterine life may result in ears that appear much bigger and even considered unsightly in some cultures
Prominent ear correction, also known as otoplasty, is a surgical procedure that changes the shape and position of the ears to create a more balanced appearance. A combination of surgical techniques is done and is ultimately dependent on the characteristics of the prominent ear, such as removal of certain parts of ear cartilage, scoring, otobrasion of other parts of the ear cartilage, as well as the placement of mattress sutures to correct the angulation and the prominence. 
Congenital ear deformities in newborns, often a result of external forces on normal ears like malposition while sleeping or pressure from the birth canal, occur with an incidence between 6 and 58%. 
For young infants with prominent ears, moulding can produce a good result as the structure in their ear cartilage is still elastic and susceptible to pressure changes — making it easier to correct prominent ears without any invasive treatment. For adults and adolescents, however, the calcification or hardening of the ear cartilage might mean that surgery would be needed for protruding ear correction. In fact, in some older individuals, the degree of calcification might mean that otoplasty may not yield good results or have a high failure rate, where the ear returns to its previous prominent position.
Depending on the individual characteristics of the prominent ears, the surgical correction may involve the removal of certain parts of the ear cartilage or scoring and otobrasion of the cartilage. Typically the ears are assessed in thirds, with the top ⅓ being the prominent helix, the middle ⅓ being the prominent concha, and the lower ⅓ being the prominent earlobe, which is rarely in need of correction. During the surgical procedure, mattress sutures will be placed in the treatment area to correct the angulation of the ears and their prominence.
During your consultation, the plastic surgeon will discern what combination of surgical techniques will be needed to achieve the best aesthetic outcome possible. At Allure Plastic Surgery, protruding ears can be corrected using Dr Samuel Ho’s hybrid technique of suture and cartilage abrasion and excision with the surgical incision well hidden in the fold of the ear.
For your comfort, you will be put under local anaesthesia with some intravenous sedation. At the patient’s request, general anaesthesia is also available. The procedure usually lasts about 1 to 2 hours, depending on the complexity of the surgery, severity of the prominent ears and how much correction is desired.
Post-operative aftercare usually involves having compression bandages over your ears for a few days after surgery. This is then replaced by a headband during your first follow-up with your surgeon.
Patients will be able to return to work a week after surgery and should avoid strenuous activity which is high in intensity. Patients should also avoid touching or sleeping on the treatment areas.
Not all ears are built the same. In some rare cases, patients may have ear deformities such as Stahl’s ears, lop ear or cryptotia, which is part of the top ear which is hidden under the scalp skin. These rare conditions require careful assessment in order to achieve a good correction.
After careful consideration with the surgeon, ear correction should only be performed after a detailed consultation with the patient’s surgeon. Although there are no perfect pair of ears, it ultimately boils down to what the patient is happy and comfortable with and what would best frame their face. Therefore, it is important to communicate both your needs and wants with your surgeon so that they may work with you in finding the best surgical outcome for you.