Otoplasty or ear correction surgery, can be a life changing
procedure for people who have been self conscious about their prominent ears.
Sometimes.
people are find that a few months after having their ears pinned back with surgery, their
ear position regresses, and looks prominent again.
This can be frustrating, after investing time in undergoing the procedure and recovery , not
mention the expense.
In my experience, the probability of significant regression of prominent ears after surgery
can be minimized through choices made by the surgeon as to procedures which will be most
effective toward achieving long term stability.
I’m Dr Amiya Prasad.
I’m a Board Certified Cosmetic Surgeon and Fellowship Trained Oculofacial Plastic Surgeon.
I’ve been in practice in Manhattan and Long Island for over 20 years.
I have been performing cosmetic ear surgeries throughout my career.
Ear aesthetics often come up during consultations for facelift surgery such as prominent ears,
elongated or enlarged earlobes.
In addition, I see patients routinely for earlobe deformities after facelift surgery
such as “pixie ear” deformity.
In addition, since many people travel to ur office for procedures form around the world,
I’ve always focused on procedures with highly predictable outcomes with maximal longevity.
In order to understand why some people experience regression of their otoplasty procedure, it’s
important to understand the of analysis of the different aspects of the ear which contribute
to ear prominence and the appropriate procedures which would be indicated based on the analysis.
This doesn’t mean that some regression can occur with appropriately performed surgery.
In addition enhancements may be necessary since the healing process can impact the final
appearance.
When I look at the ear, I divide it into upper, middle and lower thirds.
The upper third can be prominent because of underdevelopment of an area called the antihelical
fold.
The middle third is an area called the conchal bowl.
Prominence in this area can be due to a condition called conchal bowl hypertrophy.
Last is the lower third which is the earlobe.
Planning ear surgery involves taking several measurements which guide the choices as to
the types of surgery to be performed.
For example, for absence or limited development of the antihelical fold, surgery is performed
to weaken the ear cartilage and place permanent sutures called Mustarde’ sutures.
Sometimes a suture can break and needs to be replace or the cartilage may regress partially
due to something called cartilage memory.
This term cartilage memory refers to the limited elasticity of ear cartilage and tendency of
the cartilage to return towards its original shape.
In my experience, this particular issue is relevant in management of the middle third
of the ear, which when prominent is due to conchal bowl hypertrophy.
This basically means there is too much cartilage present which is pushing the ear more outward
than is desirable.
I generally perform removal or resection of part of this cartilage.
Some surgeons prefer to use sutures to pull this cartilage toward the scalp which in my
opinion can result in higher likelihood of regression due to cartilage memory.
Lastly, position of the earlobe can be corrected by some skin removal which is very effective
in improving the position of the earlobe without any issue related to cartilage.
As mentioned earlier, some drift in position of the ears can occur related to the healing
process.
As long as there is no obvious asymmetry, most patients are satisfied, particularly
when they see their preop photos in comparison.
In my opinion the appearance of prominent ears can be improved with detailed planning
and choosing the procedures which are most likely to result in stability in the long
term.
During consultation, its important for you as a prospective patient to understand these
concepts before moving forward with surgery.
I hope you found this information helpful...thank you for your question.