If there’s one facial stigma that gets more negative responses than others, its prominent
ears or bat ears.
This class one abnormality is entirely cosmetic and isn’t serious enough to be life threatening
and so makes for easy pickings without feeling guilt or pity, especially by children.
Children pay more attention than adults to small differences in appearance between themselves
and others and so when they see someone with large, protruded ears, they become the butt
of all jokes which has serious behavioural effects growing up.
Studies show that.
protruding ears have been associated with inferior cognitive performance at school,
immaturity, less favorable personality traits, diminished self-confidence, and social avoidance.
Children act out as a result of their facial features without themselves understanding
the serious downward spiral at play.
Measuring the effect of corrective otoplasty (where the ear is pinned back) using tests,
such as the Child Behavior Checklist, the State-Trait Anxiety Inventory for Children,
and the Children’s Depression Inventory, revealed improvements in almost all the assessed
items after the procedure.
In the media they pick characters with protruded ears to portray low intelligence.
In fact, large, prominent ears elicit more negative reactions in both the patient and
onlookers than any other feature.
One such reason could be that it affects only 5% of the population with facial deformities,
which itself is 10% of the total population.
In Germany it was estimated to be between 1:2000 to 1:20000 births having an ear related
deformity.
It has a rarer occurrence and so it’s all the more noticeable when someone does have
it.
It’s unlike having a big nose, thin lips or a large forehead, because those features
are more common in certain ethnicities than others.
Now Ear length and size does vary by ethnicity with the Indian subcontinent having the largest
and Afro Carribeans having the smallest, however, unless you’re a bat, protruded, outward
turned ears are not a feature of any ethnicity and instead vary by individuals.
Proposed causes may include genetic factors, point mutations, but also environmental influences
during pregnancy, such as exposure to X-rays,hypoxia, as well as the intake of certain drugs, such
as thalidomide
Ear anatomy is defined by many different parameters because its such a unique and complex shape
so we’ll go through them as they appear.
Protruded ears have a combination of three main features to them: 1) an increased helix
mastoid angle which is the angle between the helix or the top of the ear and the angle
it forms with the head.
This causes more of the ear to be more exposed and rounded from a frontal view like a cartoon
monkey.
Sometimes even with a normal helix mastoid angle, the ear may still appear protruded
due to antihelical hypoplasia where the antihelical structure isn’t fully formed to pin the
ear back.
The antihelical structure is the part of the ear the curves backwards towards your head
right at the end.
Without it, the ear curves outwards like a fleshy sound collecting bowl.
Research by Alexander Et al 2010 shows that an unfolded or incomplete antihelix accounts
for 73% of the ear’s prominence
Hypoplasia means incomplete development, Hyperplasia refers to enlargement or over development.
Which leads us to the third way of defining a protruded ear, cavum hyperplasia where an
overdeveloped cavum curves the entire ear structure and pushes the earlobe and helix
out further, making them more prominent.
In contrast, a normally developed ear has a distance of 6 -20mm from the helical rim
and the head with a helix mastoid angle of less than 30 degrees.
As previously explained this angle is the angle between your ear’s external structure
and the head, like a door hinge.
Having an ideal helical distance is then obviously dependent on having an ideal ear angle by
simple trigonometry.
These cutoffs were chosen by finding an acceptable average from 100 adults and 50 children (Rubin
1962).
There were no significant variations in prominence by gender or race in another study of 2300
ears although ear size and shapes do vary.
Also, the axis of the ear should be near parallel to the bridge of the nose and the auricle
should be approximately one auricular length (55-70mm) behind the lateral orbital margin.
The ear is an organ consisting of an internal and external structure and so auricle refers
to the entire outer structure.
Lateral means towards the sides and orbital margin means the perimeter of the orbital
bone as explained in Episode 2.
So in other words the ear should be one ear width behind the eye socket.
Lastly, the ear width (auricle width) should be 50-60% of the ear’s length (30-45mm width,
55-70mm length)
Aesthetically speaking, is this an issue worth correcting?
One otoplasty paper suggests getting it corrected at the ages of 5-6 years before starting school
to avoid the previously mentioned negative psychosocial traits associated with protruded
ears.
At that age, it’s known that children can convey their dissatisfaction and often it’s
the parents who want the surgery done for them.
The reality is, protruding ears are such a polarizing issue that the people who have
them either feel strongly enough to have them corrected very early on or don’t bother
to ever.
Research by Alexander Et al found that what the researchers rated as ‘clinically’
prominent were very rarely considered as prominent by the test subjects in both men and women.
So it might not be a big of a deal as you get older and ‘grow’ into them.
The likelihood is that the majority of the people watching this video have anatomically
regularly shaped ears.
How you feel about them beyond that is influenced by culture and beauty standards which is a
different topic.
For instance a modelling beauty standard encourages a lower helix - mastoid angle to get a more
swept back, high fashion look.
If prominent ears are considered unattractive, then it would make sense that swept back ears
with a low helical angle would be conventionally attractive, regardless of the ear shape.
So this week, I put out a poll asking what video people wanted to see and the defining
beauty series won out overwhelmingly so that's why there’s back to back uploads this week.
A couple of updates, we’re 2-3 days away from the launch of our Facial aesthetics report
depending on your timezone.
The report analyzes your face and applies cephalometric measurements, much like the
ones covered in this video on the ear, but for every facial feature to help you make
more informed decisions.
Depending on the tier you choose, they go more or less in depth and we’ve really tried
to price them so that they’re accessible to everyone but also balances our time and
resources too.
Lastly, if you're new to the channel, do subscribe, we’re almost at 100k.
There’s really interesting research coming out on how attractive faces can dilate our
perception of time which we’ll be covering very soon.