Plastic surgery restores form and function through reconstructive procedures, cosmetic enhancements, and body contouring.
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This procedure specifically targets the upper third of the ear. In many patients with prominent ears, the natural fold that curls the rim of the ear backward is missing or poorly defined. This results in the top of the ear sticking straight out from the head.
The surgeon accesses the cartilage through an incision on the back of the ear. Permanent sutures are placed in a mattress fashion through the cartilage and tightened. This tension forces the cartilage to bend, creating a new, soft fold that pulls the upper ear closer to the head.
Conchal setback addresses the middle and lower parts of the ear. It is performed when the conchal bowl the bottomless cup of the ear is too large or too deep, pushing the entire ear structure away from the skull.
The surgeon uses sutures to anchor the conchal cartilage to the mastoid fascia, the connective tissue covering the bone behind the ear. Tightening these sutures reduces the angle between the ear and the head, effectively recessing the bowl.
Most patients present with a combination of a deep bowl and a lack of a fold. Therefore, the most common procedure involves a combination of both antihelical folding and conchal setback. This comprehensive approach ensures the ear is balanced from top to bottom.
The surgeon typically performs the setback first to establish the ear’s base position. Then, the fold sutures are placed to refine the upper contour. This sequential tightening allows for precise control over the final shape and projection.
In adult patients or those with particularly stiff cartilage, sutures alone may not be enough to create a permanent fold. The cartilage may have a strong “memory” and try to spring back to its original shape. To prevent this, the surgeon employs scoring techniques.
Using a fine instrument or a rasp, the surgeon gently scores or thins the anterior surface of the cartilage. This weakens its structural integrity just enough to allow it to bend easily without breaking. This makes the suture fixation more secure and reduces the risk of relapse.
Earlobe reduction is often performed alongside otoplasty or as a standalone procedure for aging ears. Large, pendulous lobes can detract from the ear’s appearance and may not align with a newly set back ear.
The surgeon removes a wedge or crescent of tissue from the lobule. The edges are then sutured together to create a smaller, more youthful shape. This can also address earlobes that heavy earrings have stretched over time.
A shell ear is a specific deformity where the ear lacks most of its natural folds and curves, resembling a simple cup. Correction of a shell ear is more complex and involves extensive remodeling of the cartilage framework.
The surgeon must create both the antihelical fold and define the conchal rim. In some cases, cartilage grafts may be needed to build the missing structures. The skin envelope is then carefully redraped to conform to the new, more complex architecture.
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Stahl’s ear, also known as “Spock ear,” is characterized by a pointed upper ear and an extra fold of cartilage in the scapha. This gives the ear an unnatural, elfish appearance.
Correction involves excising the abnormal third crus (the extra fold) and reshaping the upper helix to create a rounder, more natural curvature. The cartilage is often reoriented or flipped to fill defects and smooth the rim.
The consultation is the most critical step. It determines patie
Constricted ear, or lop ear, is a condition where the rim of the ear is tightened, as if a drawstring were pulled. This causes the ear to curl forward and look smaller than usual. The degree of deformity can range from mild to severe.
For mild cases, the skin and cartilage can be released and expanded. For severe cases, cartilage grafts from the rib or the other ear may be required to develop the framework and give the ear normal height and width.
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Revision surgery is performed to correct unsatisfactory results from a previous otoplasty. This may involve correcting asymmetry, addressing an ear that was pinned too far back (telephone ear), or fixing a recurrence of protrusion.
Revisions are technically more challenging due to the presence of scar tissue and altered anatomy. The surgeon may need to remove old sutures, release scar bands, and use grafts to restore natural contours.
Ears are a common site for keloid formation, often following trauma or piercing. While not a cosmetic otoplasty in the traditional sense, removing these growths is a common ear surgery.
The surgeon excises the keloid tissue while preserving as much of the ear’s shape as possible. This is often combined with steroid injections or pressure therapy to prevent recurrence. In some cases, superficial radiation therapy is used immediately after surgery.
A “telephone ear” deformity occurs when the middle part of the ear is pinned back too aggressively, while the top and bottom protrude, resembling an old-fashioned telephone receiver. This is usually a complication of poor surgical technique.
Correction involves releasing the overly tight sutures in the middle third of the ear. Occasionally, a cartilage graft is placed in the middle section to push it back out, restoring a harmonious curve from top to bottom.
This procedure repairs earlobes that have been entirely torn through or elongated by heavy earrings. It is a common request that can be done under local anesthesia.
The surgeon freshens the edges of the tear by removing a small amount of skin and then sutures the front and back of the lobe together. A Z plasty technique may be used to prevent notching at the rim of the lobe.
Incisionless otoplasty uses stitches placed through the skin without making a large cut. While it has a faster recovery, it is only suitable for particular, mild cases. It has a higher recurrence rate than traditional open techniques because the cartilage is not weakened or scarred into place.
Yes, unilateral otoplasty is performed when only one ear protrudes. The surgeon carefully measures the “normal” ear and adjusts the prominent ear to match its position and projection as closely as possible.
A pointed or “Stahl’s ear” is corrected by removing the abnormal cartilage fold that causes the point and reshaping the upper ear to be round. This often involves repositioning the cartilage to create a natural curve.
If ears are pinned too tightly, they can look unnatural and plastered to the head. A revision surgery can be done to release the sutures and allow the ear to spring forward slightly, restoring a more natural position.
Ear reduction, or macrotia surgery, involves removing a wedge of tissue to reduce the size of the ear. The scars are hidden in the natural folds of the ear and are usually very difficult to see once healed.
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