Ears that extend further than two centimeters (three-quarters of an inch) from the head are considered prominent or protruding. Protruding ears are not associated with any hearing development issues. Constricted ears are ear deformities where the helical rim is either folded over (lop ear), wrinkled, or tight. Constricted ears can cause issues with hearing.


Prominent or Protruding Ears

Prominent ears are distinguished by their size and are typically due to an underdeveloped antihelix, the inner ridge of the ear that creates a “c” shape. When the antihelix does not form correctly, it causes the helix, the outer rim of the ear, to protrude more than normal. It is also common to have a deep concha, the bowl-shaped space of the ear, which results in the entire ear being pushed away from the side of the head.

Constricted Ears

Constricted ears, including conditions known as lop or cup ear deformities, affect the top rim of the ear, making it folded, wrinkled or tight. They can range from mild to severe. In mild cases, the top part of the ear alone may be folded over, and this is known as lop ear. In more severe cases, the cartilage of the helix may be tightly rolled due to a lack of skin or cartilage in development.


Ear deformities are diagnosed at birth through a physical examination. In some cases, ultrasounds before birth can detect deformities. Children with any ear deformity will be closely monitored for hearing and developmental issues to determine the most appropriate treatment.


Prominent or protruding ears can be treated with ear molding if started in the first few weeks of life. If after molding, further treatment is required, surgical reconstruction, called setback otoplasty, is an option between five and six years of age when ears are almost fully grown. However, in most cases of prominent or protruding ears, there is no urgency because there is no associated hearing loss.

Constricted ear deformities can also be treated nonsurgically through ear molding within the first two weeks of life, and then later with reconstructive surgery if necessary. In severe cases of constricted ears, some structures of the ear may be missing at birth, requiring surgery to correct the issues. Children who undergo any type of treatment for ear deformities will be monitored for hearing and developmental issues through the early years of life. Our team of specialists at the North Carolina Cleft and Craniofacial Center provide comprehensive care through reconstruction, surgery, therapy and future checkups.