Prominent ears are usually caused by lack of development of the antihelical fold, a crease in the cartilage located in front of and roughly parallel to the outer rim of the ear. Without this fold (which acts as a crease, folding the ear close to the head), the rim of the ear juts out. Another cause for prominent ears is overdevelopment of the concha, the cartilage that joins the ear to the head. Otoplasty addresses both of these problems by reshaping the cartilages.
Ear surgery generally should be delayed until children are at least 6 years old, as the ears are about 85% of adult size at that point. There is no upper age limit on surgery, though ear cartilage is generally easier to shape in children and young adults than in older adults.
Dr. Friedman makes the surgical incisions for otoplasty in the creases behind the ears. Although there are scars, they are concealed. There are no scars on the outer parts of the ears.
Although Dr. Friedman occasionally operates on one ear, most patients prefer to reduce the prominence of both ears. If there is significant asymmetry of the ears prior to surgery, it will likely be improved by otoplasty but will probably not be 100% corrected. Keep in mind that once your ears are closer to your head, it will be difficult to view both of them at the same time. So any residual asymmetry will probably be subtle.
Although most people with protruding ears feel that their ears are too large, the reality is that they are usually normal in size—they just stick out too much. The goal of otoplasty is to make the ears less prominent (as opposed to many other cosmetic surgery procedures, where the goal is to increase the prominence of a feature). Once the surgery is done, the ears may have the illusion of being smaller. Some patients (usually adults) will request reduction in the size of the earlobe (see above), which may be performed alone or in conjunction with otoplasty.