Why do my ears lack a fold/helix at the top? (photos)

Enlarged scapha and underdeveloped anti-helical fold can result in an Elf looking ear.If a condition does not bother a patient then our "well meaning" friends or family should keep their opinions to themselves.Please use this information when consulting in person with an experienced Board Certified Plastic Surgeon prior to making treatment decisions.

You do have a slight anti helical fold in both ears.  Accentuating the fold (as is typically done in a regular otoplasty) would not improve the "long" appearance of the ear. There is a lot of distance between your anti helical fold and the helical rim of the ear. The area between the anti helical fold and the rim is called the scapha. A scapha reduction would help decrease the size (surface area) of your ears to make them proportionally smaller. Slightly more reduction of the scapula could be done on the left side where the rim is more ponted to create a more rounded contour to the rim.