Can An Otoplasty Be Partially Reversed?
Q: Dr. Eppley, I had an otoplasty about 15 years ago that I was never completely happy with. While it did pull my ears that stuck out back, I always felt that it was pulled too far back in the middle making the shape of my ears look funny. I lived with it all the years thinking that I would just get used to it but I never have. In doing some research I got the impression from reading several doctor’s comments that nothing could be done, that it was unfixeable. I know that you a very creative and innovative plastic surgeon, so have you ever tried to reverse an otoplasty with any success.
A: When an otoplasty is overdone, the outer rim of the ear (helix) drops out of view behind the antihelical prominence. This is most manifest in the middle of the ear as you have described as this is the center of the arch so to speak. While sutures used to create the bend in the cartilage, what really holds the ear back long-term is the growth of scar tissue between the two sides of the cartilages. Some amount of otoplasty reversal is possible in my experience. But simply releasing the scar tissue between the two sides of the cartilage will not make it magically spring out again. This might be effective in the first several months after surgery but not after so many years. The scar tissue must be released//removed but that is not enough. The cartilages must be scored and then a small cartilage graft placed between the sides of the released ear cartilage like a spring. This will help hold in out as it heals and prevent total recurrence of ear shape. One can usually get 3 to 5mms of outward helical rotation/show. The cartilage graft can conveniently be harvested from the concha which is right next to the release site.
Dr. Barry Eppley