What made Paul pin back his ears?

Paul from Big Brother says it changed his life. And otoplasty is now one of the most popular types of plastic surgery for men,

Entering the Big Brother house must have been one of the more significant moments in housemate Paul Clarke's life. This week, following his ejection, Paul told the nation about another: his operation at 16 to pin back his sticking-out ears. "One of the most important things in my life was having that operation," he declared.

He is not alone. Otoplasty (ear surgery) is now among the most common plastic surgery procedures for men. Last year, for instance, it made up 15 per cent of operations at the Harley Medical Centre.

Surgery could seem a drastic measure to change what the unafflicted may see as "cute", but for those who are unhappy about their appearance, it can be a permanent ache. Men, in particular, find that the slightly comic appearance of protruding ears can make it hard for the them to be taken seriously and it can even affect their careers.

Diane Hansen, group director of nursing at the Harley Medical Centre, points out that the emphasis on how men look has contributed to the move towards surgery. "The big change in the range of cosmetic surgery available increases men's options. It is a very serious decision, but it seems like a natural step," she said.

Jamie Graham was tired of the jokes and jibes about his ears and decided to investigate otoplasty last year. At 24, he fitted into the most common age bracket of those treated, but the problem had worried him since childhood. His mother always told him he was perfect the way he was, but with hindsight he wishes he could have had surgery at a much younger age. "As you get older, it really matters if you're self-conscious, especially at school or when you start going out. I would recommend parents to think about it for their children," he said.

It could be a prudent piece of advice, financially at least. While children under the age of 16 can get the operation on the NHS, an adult will pay £2,000.

Whatever the decision, it is easy to wax lyrical about results, but important not to forget about the process. Is ear pinning as gruesome as it sounds?

The professionals sometimes call it "ear reshaping", but either way, the operation involves making a cut in the groove at the back of the patient's ear where it joins the scalp. There is then an excision of a strip of cartilage: this is what the ear is made up of under the skin, so once it is removed, the ear can be folded back. It is then stitched into position, and remains closer to the patient's head.

In all, the procedure usually only takes an hour under sedation or general anaesthetic. A turban bandage is then secured around the patient's head for a week, after which they should be well enough to return to work.

Graham cautions, however, that the results are not instantaneous. "It was upsetting for my fiancée and me, especially on the day of the operation. Because of the mess of dry blood and swelling, my ears didn't even look anything like ears." Thinking of the "before and after" photos of other patients that he'd seen at the hospital, he panicked. "I was really scared that I'd made an awful mistake and wasted my money. I phoned the hospital immediately to see if this was normal, but the sister there reassured me that the swelling would go down."

But are there risks? Aside from the reaction to sedatives, the potential problems mainly seem to be aesthetic. It is, for example, impossible to ensure that symmetry will be achieved, and yet this is a minimal factor, as ears that don't naturally protrude are themselves rarely even. The other main risk is the extent of bruising and swelling that occurs.

Graham's ears remained badly swollen for a couple of months after the operation, and were still tender to touch for about six months. This is, says Hansen, an exceptional case, and dependent upon the individual. Little things – like staying upright as much as possible – can determine the length of time the bruises stay, and where the swelling diminishes. Ultimately, the swelling will go down and the small scar behind the ear may also disappear.

"When the patients come back for their final check-up, it's astonishing how many have had an image change," Hansen laughs. "Many had grown their hair long to hide their ears before, but have a new haircut in the 'after' photos."

The inner confidence that otoplasty affords its subscribers seems to be the key. Graham was surprised how many people didn't notice a difference until he pointed it out, while for him it was everything. "It's a nice thing to find out that people weren't judging me by my looks. I'm glad I had it done though, because I realise it was just for me. I feel like it's a new start."

Harley Medical Centre, freephone 0800 917 9000