How Brittle Ear Cartilage Can Change Shape after Previous Surgery, and How it is Revised

A gentleman had otoplasty (cosmetic surgery for the ears) before. However, his ears are still prominent and wants to know the best procedure to address his ear problem. Dr. Amiya Prasad is a board certified cosmetic surgeon. Otoplasty is a procedure he performs in his practice and he can certainly give his perspective based on some anatomic principles. This can help patients understand how to choose procedures. The area where there is an excess tissue is in the central part of the ear and this is called the conchal bowl. Prominent ears are related to increased protuberance of the conchal bowl and are called conchal bowl hypertrophy. To correct this, Dr. Prasad resects or reduces the cartilage and reattaches it to the side of the scalp in the area called the mastoid fascia. That procedure is more anatomic in comparison to other procedures that are sometimes offered like the setback procedure which is done particularly for patients whose cartilage is soft. Dr. Prasad has a suspicion that this is the procedure that this gentleman had done where sutures were used to pull the ear back into position. However, because the cartilage is a little brittle, it can break and create this potential irregularity. Unfortunately, Dr. Prasad wasn’t there for the original surgery so he can’t say exactly what happened. A physical exam is helpful to determine his problem. If he is bothered with his ears then that can be addressed. There is also an upper part of the ear which is referred to as the antihelical fold. The common issue for people who have prominent ears is the absence or lack of development of the antihelical fold. There are procedures, particularly one called the Mustard procedure where the sutures are placed in a certain way after the cartilage is weakened to try to recreate an anatomic fold. Dr. Prasad suggests that this gentleman meet with doctors who perform otoplasty. It is a very interesting procedure that can have a dramatic improvement. If he wants to do both ears while one ear is the one that bothers him, he has to measure and compare it to the other ear and how it is projected away from the skin. There are a lot of nuances that can’t all be addressed with just a single photo with one angle. Based on the photo he submitted, some type of revision surgery is possible. For more information about ear surgery, please visit our site: http://prasadcosmeticsurgery.com/pras...