Ultimate Guide to Ear Shape

Infants born with misshapen, large, or protruding ears often develop a poor self-image and find themselves socially isolated. An earlobe reduction or otoplasty surgery can correct ear deformities and significantly increase the quality of life for many patients. However, as with all surgeries, there are some risks.

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Ear shape affects hearing, balance, and self-image. The human ear presents in an unlimited variety of shapes and sizes. Sometimes, genetic mutations cause earlobe deformities or other ear anomalies that lead to functional and/or aesthetic problems. These are quite common, occurring in about 15% of the four million-plus babies born in the United States each year.

The shapes of our ears change constantly, although very gradually, throughout life. In the past, many doctors thought that most ear deformities would naturally correct with age. However, this turned out to not be true. Research has shown that about 70% of infants with misshapen ears retain them into childhood and beyond.

Enhanced understanding of ear anatomy and advancements in biomedical engineering and reconstructive surgery techniques have led to new treatment options for correcting ear deformities. Now, babies born with malformed or overly prominent ears can be treated in various manners before they reach their early childhood years.

Before reviewing the different types of ear deformities and how to correct them, it is good to understand some of the basic terms used to describe the ears and their functions.

Ear Anatomy Terminology

Ear anatomy can be somewhat confusing as the ear has two very important functions: hearing and maintaining balance. The three primary areas of the human ear are simply referred to as the inner, middle, and outer ear. All three components of the ear are necessary for hearing but only the inner ear is involved with vestibular (balance) functions.

The following are some of the most common terms used for describing the ear.

Concha: hollow region in front of the ear canal that’s shaped like a conch shell Pinna(auricle): outer part of the ear comprised of cartilage, skin, and fat tissue Earlobe: soft, non-cartilaginous, bottom part of the pinna Eardrum(tympanic membrane): membrane that separates the outer ear and middle ear External auditory canal: curved tube that extends from the auricle to the eardrum Helix(crus): curved outer rim of the ear Antihelix: curved inner rim of the ear Tragus: small bump in front of the ear canal

The visible part of the pinna is a combination of the antihelix and the helix. Together, these components extend into the opening of the ear canal.

The outer ear is the portion that determines the shape and size that are associated with “the ear”. It is made up of the pinna, the ear canal, and the membrane that forms the boundary of the eardrum. Of those, the pinna is what dictates ear shape.

Ear Shape Deformities

Outer ear and earlobe deformities occur in various sizes and shapes. These ear anomalies include:

Anotia: complete absence of the outer ear Aural atresia: absence of the ear canal Constricted ear: an ear with a tight, folded, or wrinkled helical rim Cryptotia: when part of the ear cartilage is positioned under the skin on the side of the head Cauliflower ear: misshapen ears that form due to abnormal cartilage accumulations Ear keloids: scar tissue accumulations that form because of minor trauma like ear piercing Ear tags: excess skin and/or cartilage due to an overly large tragus, or a branchial cleft Microtia: when the external ear is not completely developed Protruding ears(prominent ears): when ears of any size stick out from the side of the head more than 2 cm Stahl’s ears: an extra fold in the cartilage of the upper ear that causes a pointed appearance Folded Ears: a folded ear is a type of ear deformity that is commonly called “lidding”. It is present at birth and marked by a cartilage fold in the upper portion of the outer ear. It makes the ear appear to be “crunched” together on top as if an internal string cinched it.

Folded ears are not uncommon in newborns and they do not normally cause hearing abnormalities. However, if they are not addressed with reconstructive surgery, then they will remain with the person throughout life, which often causes self-confidence issues, depression, and social anxiety.

Other causes of ear deformity include split earlobes caused by wearing heavy earrings, lacerations, tears, bites, and other trauma.

Ear Shape and Age

Our ears continue to change shape and size as we age. It is a slow process that gets progressively quicker as the years pass. The main reasons for this are:

  • Loss of collagen and elastin which are needed to maintain skin elasticity
  • Increased fat tissue volume that is common with sedentary living
  • Chronic use of ear jewelry that weighs the ears down
  • The downward-pulling effects of gravity

Collagen loss is one of the primary causes of skin sagging and drooping with age. Further, routine exercise throughout life is important for many reasons, including reducing the amount of fat that the body, including the ears, stores. Conversely, a sedentary lifestyle causes the body to store more fat, which can add volume and weight to the ears.

Fixing the Ear Shape with Surgery

In some cases, an infant can wear an ear molding device to help train misshapen ears and thereby avoid a deformity progressing into childhood. However, correcting outer ear deformities commonly requires surgery. Some procedures can alter the size and shape of a child’s ears so they can hear better and other procedures that are performed simply to enhance the appearance of the ears.

There is no known way to determine which ear deformities will self-correct later in life and which will continue to progress with age. It is important to discuss the best treatment option for you or your child with your doctor.

The two primary surgical techniques used for enhancing ear shape are otoplasty and earlobe reduction:

Otoplasty Otoplasty surgery is performed on patients of all ages and can refer to several aesthetic improvements to the ear. It moves prominent ears closer to the head and reduces the size of overly large ears. It is commonly called “ear pinning” and is a safe procedure for permanently repositioning the ears. This outpatient procedure is typically performed during childhood when the ears have completed most of their development.

Earlobe Reduction Those with fleshy, pendulous earlobes due to aging or other factors can benefit from an earlobe reduction procedure. This surgery is performed on an outpatient basis, produces permanent results, and helps to balance the appearance of the ears to the face. This very often helps patients to find renewed self-confidence and feel the increased quality of life.


In most cases, an ear molding device is not enough to correct a congenital ear deformity. However, reconstructive ear surgery is often successful for reducing the size of overly large ears, altering misshapen ears, or moving protruding ears closer to the side of the head to enhance facial aesthetics.

For infants, correcting ear deformities prevents them from growing up with ears that detract from their appearance, which often causes problems like social awkwardness and depression. For adults, surgical correction of deformed ears can significantly strengthen the self-image. Talk with your doctor about the best course of action for correcting the shape of your ears

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