Imagine being a small child, constantly being made fun of because of your ears. What if you were bullied every day, taunted by the other kids who called you "Elf ears"?

What would that do to your self-esteem, and what lasting scars would it make? It's difficult for adults to be stared at and laughed at, but for a child, it'd be excruciating. 

And that's why, in 2015, first-grader Gage Berger had a cosmetic surgery called an ear pinback (Otoplasty) done to fix his very prominent ears.

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Berger told Inside Edition that he was picked on by the kids at his Salt Lake City school and that the other children said, "that I look like an elf and I have weird ears." Explaining further, he said, "I just don't want to be made fun of." 

Photo: Inside Edition

Steven J. Pearlman, MD, facial plastic and reconstructive surgeon said, "If you look at cartoons depicting individuals of lesser intelligence, they are often drawn with big, protruding ears. It's harder [for the child] to make friends so they become socially stunted. They are also perceived as less intelligent by peers and even adults."

Bullied kids are also at an increased risk of having anxiety disorders, depression, and suicidal thoughts well into adulthood.

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A 2013 study from Duke University showed that while the common perception that bullying (while painful) wasn't lasting, it actually has a long-term effect on the victim — one that can affect not only their mental health but the overall quality of their life. 

"We were surprised at how profoundly bullying affects a person long-term," said William E Copeland, Ph.D., and the lead author of the study. "This psychological damage doesn't just go away because a person grew up and is no longer bullied. This is something that stays with them." 

Being bullied for his ears had already started to affect Berger. "He just gets really down on himself and he thinks, 'I'm not good enough,'" his mother revealed.

When faced with what years of being bullied would do to their son, and luckily having the resources, Berger's parents brought him to a plastic surgeon for the Otoplasty.

This corrective surgery is recommended for ears that stick out more than 4/5 of an inch from the back of the head.

It can be performed at any age after the ears have reached their full size, usually at five or six years of age. Having this surgery at such a young age had the benefit of his cartilage being more pliable and easier to reshape.

The surgery begins with an incision (in the most inconspicuous spot the surgeon can find) behind the ear, in the fold where the ear is attached to the head. The surgeon may remove skin and cartilage or just trim and reshape the cartilage.

In addition to correcting the protrusion, the ears may also be reshaped, reduced in size, or simply made more symmetrical. The cartilage is then secured in the new position with permanent stitches anchoring the ear. Soft dressings are placed over the ears for a few weeks as protection, and the patient normally only experiences a little tenderness or mild discomfort.

Headbands are sometimes recommended to hold the ears in place for a month following surgery or may be prescribed for nighttime wear only. Berger had his stuffed toy lion wear a headband, too.

In 2018, another young child underwent the same procedure. Like Berger, Bella Harrington was being teased for her ears.

She said in an interview, “They would always, like, point it out, but then the more people pointed it out is when I wanted to change it. I thought that they stuck out way too much.” Her mother then responded, adding, “They were teasing her over it. One thing they said, she had elf ears.”

When she was 11, Harrington got an Otoplasty. Her doctor, Dr. Joe Niamtu, said that it's actually beneficial for very young patients to get something corrected if it is due to some form of bullying.

He said, “We like to treat these children before they enter school, so it’s not uncommon that I’m doing 4- or 5-year-olds. And the reason is bullying or peer pressure. It’s been shown to psychologically to have the ability to affect their self-esteem or body image for the rest of their life."

After the surgery, Harrington said, “I wear my hair up a lot and I’m not focused on if people can see them.”

While Otoplasty surgery has reportedly become a more common thing for children recently, plastic surgery at such a young age may still not be the right decision for every child. But for Berger and Harrington, it seems they made the right decision.

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Christine Schoenwald is a writer and performer. She's had articles in The Los Angeles Times, Salon, and Woman's Day. Visit her website or and her Instagram.