From Prominent to Proportionate: Social Perceptions of Patients With Prominent Ears Undergoing Otoplasty

Prominent ears are one of the most common congenital craniofacial differences in children. While not functionally impairing, their visibility can cause psychosocial distress, particularly from peer ridicule. Otoplasty is frequently performed to modify auricular projection and normalize appearance; however, its effect on social perception by lay observers remains unclear. This study evaluated how otoplasty influences public perception of pediatric patients. Preoperative and postoperative photographs of 2 patients were rated by 998 adult respondents through an online survey. Participants evaluated each image across multiple social domains (personality traits, emotional expression, interpersonal experiences, and perceived life outcomes) using a 7-point Likert scale. Postoperative images of Patient 1 were associated with increased perceptions of submissiveness, untrustworthiness, unattractiveness, loneliness, anxiety, lower socioeconomic status, and difficulty with school, but also a greater likelihood of career success. Patient 2's postoperative images were associated with increased perceptions of dominance, unattractiveness, sadness, and social undesirability, but also reduced likelihood of low socioeconomic status. These results suggest that otoplasty may not uniformly improve social perception and that observed benefits may relate more to internal behavioral changes than external anatomic ones. Further research should explore the role of perceived age, behavior, and other visual cues in shaping public impressions.