Lop ear is a congenital deformity in which the upper third of the ear folds downward, creating a hooded appearance that can partially obscure the ear opening. It is sometimes grouped with cup ear and constricted ear in clinical classification. Correction involves releasing and unfurling the folded cartilage, then stabilising the new contour with sutures and occasional cartilage grafts.
Key Facts
Lop ear anatomy
In lop ear, the cartilage of the upper helix loses its normal vertical orientation and falls forward and downward. The helical rim, which should curve in a smooth crescent from the top of the ear down to the lobule, instead bends sharply at the upper pole. In severe cases this fold drops the helix over the conchal bowl, partially covering the ear canal opening.
The underlying problem is incomplete development of the upper antihelical structure that normally holds the helix vertical. The cartilage volume is usually normal — it is the geometry that is abnormal.
Surgical correction
Lop ear correction follows three steps. First, a posterior incision exposes the upper auricular cartilage. Second, the helix is unfurled and elevated by releasing the cartilage at the level of the abnormal fold; small wedge incisions in the scapha allow the upper ear to rotate upward into its correct vertical position. Third, the new position is stabilised with permanent sutures, supplemented by a small cartilage strut harvested from the conchal bowl in severe cases.
Total operative time is 2–2.5 hours. Recovery follows the standard otoplasty pathway — headband for 4–6 weeks, return to school or work in 7–10 days, return to sports at 6 weeks.
Combined deformities
Approximately half of lop ears coexist with prominent ear features — meaning the same patient shows both downward helical folding and outward ear projection. In these cases the surgical plan addresses both components in a single operation, combining helix unfurling with Mustardé antihelical sutures and Furnas conchal setback as needed.
Long-term outcomes
With contemporary techniques, lop ear correction achieves a stable, aesthetic outcome in over 85 percent of cases with a single operation. The remaining 10–15 percent may show partial recurrence of the helical fold within the first year, typically requiring a minor revision procedure that adds further cartilage support.
Frequently Asked Questions
Is lop ear the same as cup ear?
Different surgeons use the terms differently. Most consider lop ear a specific subtype of constricted/cup ear deformity that emphasises the downward folding component. The treatment approach is similar — release of the abnormal fold and stabilisation in a new position.
Does it affect hearing?
Usually not. Although severe lop ears can partially cover the ear canal externally, sound still reaches the ear canal opening. Audiometric testing typically shows normal hearing. If hearing concerns exist, they are evaluated separately from the cosmetic deformity.
Can it be corrected with stitches alone?
Mild cases of lop ear can sometimes be corrected with cartilage-sparing suture techniques. Moderate to severe cases require cartilage release and reshaping, because suture-only techniques cannot create the geometry change needed to restore the vertical helix.
What is the recovery time?
Recovery follows the standard otoplasty timeline — headband for 4–6 weeks, return to most activities in 7–10 days, full contact sports at 6 weeks. Final shape stabilises over 3–6 months as cartilage memory establishes in its new position.
Will the ear grow normally afterwards?
Yes. Surgery on a child's ear does not interfere with normal ear growth. The ear continues to grow in proportion with the head until approximately age 12, when growth slows. Surgical correction at age 6 produces stable shape that scales naturally with growth.