‘Elf Ears’ Are Trending in China. People Are Undergoing Surgery To Get Them.

Protruding ears may have been the target of playground bullies, but they’re now fueling a budding beauty trend in China.
Koh Ewe
Why People in China Are Undergoing Cosmetic Procedures To Get ‘Elf Ears’
A woman before and after getting dermal fillers for “elf ears.” Collage: VICE / Images: Courtesy of Hangzhou Time Plastic & Cosmetology Hospital

Song Yao, a clothing store owner in Hangzhou, China, is no stranger to cosmetic procedures. The 20-year-old has had double eyelid surgery and skin boosters done in the past. But in her recent quest to achieve a perfectly small face, she decided to do something about her ears.

“The results are very obvious. You can see my ears from the front, and overall I look more energetic,” Song told VICE. She first got her ears plumped up in May and recently added two more shots of hyaluronic acid to her ears. In total, this cost her a little over 10,000 yuan ($1,560). 

Young woman in China underwent a cosmetic procedure to get elf ears.

Song Yao before and after getting “elf ear” fillers. Collage: VICE / Images: Courtesy of Song Yao

The new beauty trend is called “elf ears” and now many women in China, like Song, are undergoing cosmetic procedures just to achieve them. Some believe enlarging ears make faces look slimmer and, therefore, more attractive. Song said that her decision to get elf ears was partly influenced by female celebrities with protruding ears.

Elf ears are just another example of China’s narrow obsession with beauty. A fixation on thinness has led to bizarre beauty challenges on social media, like balancing lipsticks on collarbones and wrapping earphones around waists. Another dangerous beauty trend sees young women reportedly undergoing surgery that intentionally damages nerves in their legs to get skinnier calves.

While not as extreme as the ear modification fad that has seen Lord of the Rings fans getting their ears clipped to Legolas-level sharpness, the elf ear trend in China has people undergoing cosmetic procedures to push their ears forward so that they’re visible from a frontal view of the face.

A woman before and right after getting dermal fillers for elf ears.

A woman before and after getting dermal fillers for “elf ears.” Collage and Images: Courtesy of Time Plastic & Cosmetology Hospital

Elf ears are commonly done by injecting hyaluronic acid (a substance usually used in dermal fillers) into the ears to plump them up. Meanwhile, some opt to insert a piece of cartilage or other material behind the ear to prop it forward.

“Protruding ears were always a form of ear deformity that required treatment, but now they’re a beauty trend,” Liu Yufeng, chief physician of the plastic surgery division at the Second Hospital of Nanjing, told VICE.

According to Liu, cosmetic procedures for elf ears also come with significant risks.

“The first is infection around the ear after surgery, which is very tricky to treat; the second is embolism caused by injecting hyaluronic acid into blood vessels, which may be fatal,” he said.

Injecting large amounts of hyaluronic acid into the ear may also cause pronounced and prolonged swelling and pain, since there are many nerve endings in the ear, he added.

A man after getting dermal fillers for one of his ears, a cosmetic procedure to get elf ears in China.

A man after getting dermal fillers for one of his ears. Image: Courtesy of Time Plastic & Cosmetology Hospital

Despite the risks, elf ears are still getting fervid attention.

On Chinese microblogging site Weibo, a Chinese hashtag that translates to “elf ears plastic surgery” has garnered over 700 million views. This includes posts of Chinese social media influencers sharing their experiences with elf ear surgery. Elf ear-related videos are also popular on Douyin, China’s version of TikTok.


“I used an app to edit my ears in a photo and realized that [elf ears] looked pretty suitable for me,” said Yi Xiao Ge, a Douyin user with close to 270,000 followers, in a video where she claims to have recently gotten elf ears through a cosmetic procedure. 

Screenshot of a Douyin video by Yi Xiao Ge, where she shared her experience with elf ear surgery.

Screenshot of a Douyin video by Yi Xiao Ge, where she shared her experience with “elf ear” surgery. “The implant is mainly inserted behind your ear,” the subtitles read. Image: Yi Xiao Ge

Beauty vloggers are now also posting non-permanent and non-invasive DIY tutorials for an instant ear lift, such as using a small hair clip or a few pieces of bandages taped behind the ear. 

Song said that after noticing her new look, some of her friends now also want elf ears. But many online are also appalled that ear shapes are now subjected to scrutiny. 

Some see the oddly specific beauty standard as an extreme manifestation of social appearance anxiety, a type of social anxiety concerning negative perceptions of one’s own physical appearance. Along with the elf ear discussion is another viral hashtag on Weibo with close to 200 million views: “What do you think of social appearance anxiety progressing to involve the ears?”

“There’s no need to tell young girls that only protruding ears are considered beautiful,” wrote a Weibo user. “They’re just ears, if they can hold up your eyeglass frames, they’re good enough!”


“Mainstream perception of beauty is always changing. Are you going to torture your face to suit others’ preferences?” wrote another.

Meanwhile, some are surprised that what used to be the subject of childhood taunting is now desirable. 

“I’m shocked that someone complimented my protruding ears as elf ears,” a Weibo user shared, adding that their childhood nickname “Big Ears” was a source of annoyance growing up.

Viola Zhou contributed to the reporting of the story. 

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