There are some pretty famous people who have protruding ears. Prince Charles for one. Men Behaving Badly's Martin Clunes for another.

But it has to be said that neither is exactly idol material (unless your name is Camilla Parker Bowles) and so sticking-out ears remain a candidate for cosmetic surgery.

Otoplasty, or ear pinning, is most commonly performed on children. "Children can be very cruel at school," says Sydney ENT and facial plastic surgeon Dr. George Marcells. "Children with prominent ears get called names like 'Radar' or 'Wingnut' and can feel self-conscious and traumatised. They are so happy to look normal and be accepted as one of the other kids. That is why we usually perform this operation at school age. It's rewarding to do."

Today much of Dr. Marcell's otoplasty work is performed on adults. Although they tend to have come to terms with any stigma, many adults may still feel frustrated at not being able to wear their hair the way they want to, for instance, and so they finally decide to do something about it.

Basically, with protruding ears, there are three different deformities and they can occur singly or in a combination:

1. Failure of the antihelix to fold (see diagram below) is the most common deformity and surgery tries to recreate the natural fold.
2. Deformities in the conchal bowl area can make the whole ear stick out.
3. Deformities in the lobule - which is the soft fleshy, lower part of the ear.

Dr Marcells says the surgeon has to accurately assess the ears and then fix each problem using a separate manoeuvre. But before performing the operation he provides a prediction of the outcome using computer and digital imagery. "This is great fun," he says, "as it's fairly accurate so people get really excited and it helps with the anticipation."

The operation is done under general anaesthetic and takes between one and two hours. It involves making an incision behind the ears so there are no obvious, visible scars, and then it is a case of cutting, bending and folding the cartilage to make the ear bend back.

"I may have to weaken the cartilage and put in three to four little sutures to create a fold. If the cartilage is very strong, I have to use a diamond bird drill to soften it," Dr Marcells says. "Also sometimes with the concha I have to excise soft tissue and cartilage to allow it to sit back. There is not a lot of pain afterwards, although a little tightness around the ears and head might be felt, and it is day-only surgery, even for kids."

Afterwards, patients have to wear a head bandage for one or two days to keep the ears secure. They then have to wear a wide, comfy headband constantly for a week, and then for a further two to three weeks in bed only. This keeps the ears folded nicely back.

Dr Marcells says he is happy for children not to wear the band to school if they feel self-conscious but added that it's a good idea to keep the child off school anyway for a week as the wounds are still healing. "There may be a bit of swelling and you don't want the ears knocked," he says.