When a plastic surgeon corrects a prominent ear using an otoplasty (ear pinback), it is important to pin the ear back in the central and lower parts of the ear as well as the upper part. The ear position should be as close to normal as possible.
Studies show that the normal distance from the head to the upper part of the ear is about 10-12 mm, it is 16-18 mm in the middle ear and 20-22 mm in the lower ear.
It is unusual for the ear to protrude again after surgery. If this occurs it is usually due to stitches breaking from an injury or when stitches are rejected by the body. In adults this may reflect rigid cartilage or in children very springy cartilage. When this happens additional surgery is usually needed. Sometimes it is necessary to change the technique of surgery, perhaps cutting through the cartilge leaving a more sharp outline to the folds of the ear.