Thank you for your question.
You submitted your question with a single photo.
You state in your question that you had an otoplasty done a week prior and you’re concerned
about the appearance of your ear.
You addressed this concern with your surgeon who stated that the final appearance will
occur in 3 weeks.
And so, I think you are looking for additional perspectives as to whether or not the appearance
is normal.
Well, I can certainly share with you my perception based on a photo alone and in the absence
of a physical examination and the details of your surgery.
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 procedure that is performed in our practice and certainly, what I believe
is the intention of your otoplasty is something I can help you understand and give you some
guidance as to what may be the issue at this point.
So to begin with, when you analyze the appearance of an ear for a patient who feels that it
is prominent, we basically look at the ear in thirds.
And essentially, we look at the area known as the antihelical fold which appears to be
the area that was treated in your surgery.
There’s an area called the conchal bowl and then there’s the earlobe.
And we look at each area in terms of the relative position and determine what type of procedure
to do.
Now in your situation, I suspect the goal was to create an antihelical fold to help
the upper part of the ear to the mid part basically get closer.
And generally speaking, a standard approach to this is referred to, we’re using something
called mustarde sutures.
And what this means is from the back of the ear, the skin is elevated and the cartilage
is weakened in a variety of different methods based on the surgeon’s preference.
And permanent sutures are used to create a fold from the back so that the antihelical
fold becomes created and defined.
Now, depending on your surgeon’s style and individual surgeon’s style, some like to
make this more tight versus others.
I think there is a certain amount of variability.
I think one of the things that can be challenging about otoplasty has to do with the nature
of the cartilage itself.
Cartilage is basically a type of tissue which is something we call memory.
And what that means is that, as time goes on, there can be a little bit of regression
based on the original position of the cartilage prior to surgery.
Which means that sometimes, a surgeon will be tempted to do what’s called an overcorrection
to try to compensate for that.
Now that being said, I would suspect from the appearance of your photo is that this
overcorrection might have been aggressive.
The fold may be a little bit extended than what was intended.
I think that ultimately, a little bit of time will allow for you to see where this is going
to settle.
And if your surgeon wants to and makes that decision possibly at the 3 week point, they
may want to go back and either release stitches or replace stitches depending on what their
assessment is.
Every surgeon has experience, who does this procedure that guides them how they do these
procedures.
And sometimes, regardless of how good it looks during surgery or immediately after surgery,
you have to do enhancements and that’s just part of the nature of cosmetic surgery.
Enhancements is just part of this type of work that we do.
I think it’s important that you maintain this dialogue with your doctor.
I would suspect that there is going to be some regression over the next couple of weeks.
But if this remains in this type of appearance, then some type of revision will probably be
indicated at some point based on your surgeon’s comfort.
So I hope that was helpful, I wish you the best of luck and thank you for your question.