According to Dr. Lajos Nagy, a New York plastic surgeon: "Sculpted ears not only enhance the attractiveness of the face, but also improve the experience of listening to music."
Whatever the reason, the surgical procedure has been slowly catching on with the young and daring. Body modification artist Russ Foxx has been sculpting ears for years and will only perform the operation on 18-year-olds or older, according to Shaughnessy Keely, a rep from his piercing shop, The Fall. "He'll do a few sessions and he'll sculpt your ear and make it pointy."
Put more graphically, elf ears are created by slicing the top of the cartilage on the ear and then sewing it back together.
http://www.momlogic.com/2008/08/new_trend_elf_ears.php
Whatever the reason, the surgical procedure has been slowly catching on with the young and daring. Body modification artist Russ Foxx has been sculpting ears for years and will only perform the operation on 18-year-olds or older, according to Shaughnessy Keely, a rep from his piercing shop, The Fall. "He'll do a few sessions and he'll sculpt your ear and make it pointy."
Put more graphically, elf ears are created by slicing the top of the cartilage on the ear and then sewing it back together.

http://www.momlogic.com/2008/08/new_trend_elf_ears.php