Thank you for your question.
You submitted your question with a single photo of your ear and you describe in your
question that you had an otoplasty performed years prior but it appeared to you that the
surgeon took care of part of the prominent element of the ear but never addressed the
antihelical fold and you’re asking is that possible to do in revision otoplasty.
Well, I can certainly share with you my approach to otoplasty and how I would suggest a solution
for someone like you who would come to our practice.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon.
I have been in practice in Manhattan and Long Island for over 20 years.
Otoplasty is a significant part of the many things that we do in our practice.
Again, in the absence of a physical examination, I can tell you what the systematic approach
to looking at an ear is and then what kind of solutions there are particularly for what
you are describing.
So to begin with, when you look at the ear, you look at the ear at basically thirds: an
upper, middle and lower third.
And basically, you’re looking at the antihelical fold, you’re looking at the prominence and
the structure called the conchal bowl and then you’re looking at the earlobe.
Now in your situation, if the ear has been brought back to a distance that is aesthetically
desirable, in other worlds the conchal bowl was either set back or resected, the distance
is adequate and appropriate, well then focusing on the antihelical fold is appropriate.
Now what does that mean?
Well, when I do this antihelical fold procedure, the technique I employ is referred to as a
Mustarde procedure which essentially is the use of non-dissolving sutures through an incision
made behind the ear to engage the cartilage as well as before doing that, creating a weakening
of the cartilage in order for it to bend in a predictable and consistent way.
And placing these sutures in essentially what’s called a horizontal mattress fashion.
It’s basically creating these bends and the sutures maintain that appearance so that
the cartilage stays in place.
Now where there may be a possible need for additional procedure is that if in doing that
antihelical fold or creating that antihelical fold, if the middle part of the ear looks
like it’s more prominent, well then you may need additional surgery for the middle
part of the ear.
And of course lastly, you have to look at the earlobe to make sure it’s not sticking
out too prominently and a procedure for that is fairly straightforward.
So I think to answer your question is can an antihelical fold be formed and the answer
is yes, you can create an antihelical fold in isolation in absence of doing anything
else.
And I would say that it is appropriate to do it in a more, what is considered more standard
procedure such as a Mustarde type surgery.
And basically understand that when you are being evaluated, you still want to ensure
that the elements of each one third part of the ear is in appropriate distance from the
side of the head and so that it doesn’t look like the top of the ear is folded in
too much or the middle part is too out.
There are sometimes when people look at themselves from the side and they just bend the ear,
they’re really not appreciating how they look from either the front or the back.
So you kind of have to have that discussion with your prospective surgeon.
So I hope that was helpful, I wish you the best of luck and thank you for your question.