Is there a way to change the ear angle only slightly? If so, how invasive and costly might it be? (photo)

Hello there and thank you so much for your question; it is a good one!

There are a number of ways to correct prominent ears.

The oldest procedures cut through the cartilage and although successful left a tell tale visible ridge.

One of the most common methods involves scoring the cartilage like origami to make the ears fold back but there is a degree of unpredictability some of the time as you are relying on a response to the scoring which is not always completely the same; also you are denuding the cartilage of skin and so blood supply from the front and the back; there is sometimes a ridge visible from the back of the ear where the cartilage has been cut through. Nevertheless, in experienced hands, an excellent technique which I used to use but have now abandoned.

My favoured technique is now to use the posterior method which I published about 10 years ago  (see below) is not to cut through the cartilage at all but to weaken it and then by placement of sutures very carefully, to bend the ear back. There are a number of other key surgical elements that must be done to secure a good result but the main advantages are that the result, in my hands, is much more precise and predictable and the patient can almost ask me how much back they wish the ear to be. Most surgeons who use this 'posterior approach' tend to use permanent sutures as this means less recurrence but I have worked out techniques that result in lower recurrence rates without using permanent sutures which is of course helpful for the patient as there is nothing left in the ear to cause a problem in the future.

Finally there is a new device called the 'Ear Fold' by Allergan which I am not sure is yet available in the US but you could check. This is a small implant placed under local anaesthetic in a very short operation which can be checked prior to surgery by seeing how it works with the patient awake; it is similar to a spring-like clamp and can be just attached to the ear on the surface to test how the surgical result will be - if the problem is confined purely to the blade and projection of the ear this may be all that is needed and the result should be permanent but with a thin strip placed (permanently) under the skin at the front of the ear which is not visible.

I hope that this answer was helpful for you and my very best wishes in your pursuit of elegance in your profile.



Reference paper:

Mandal, A., Bahia, H., Ahmad, T., Stewart, K.J. Comparison of cartilage scoring and cartilage sparing otoplasty–a study of 203 cases. 

Journal of Plastic, Reconstructive & Aesthetic Surgery  – JPRAS. 2006;59:1170–1176.