Cosmetic ear surgery is also known as otoplasty and can be done to improve the proportion, shape, or position of the ears. For instance, if the ears are disproportionately large (macrotia) or they protrude forward, this can be surgically corrected. When heavy earrings are worn for many years and the piercing site becomes abnormally stretched open, this can be reconstructed. Cosmetic ear surgery involves operating on the outer part of the ear and must be distinguished from those procedures performed to improve hearing (i.e. inside the ear).