Can An Overdone And Painful Otoplasty Be Fixed?
Q: Dr. Eppley, I had an otoplasty done just over one year ago. One ear is pinned back too far and the other doesn’t look or feel right; it twitches and is painful sometimes as though a stitch is holding it in place and is being pulled. I was reading comments on your website about grafts and I wanted to know how the procedure works and how much I should plan on spending. Thank you for any information.
A: Otoplasty surgery can be associated with several unfavorable outcomes. Two of such problems are the over done otoplasty ear and the painful oitoplasty ear. When the antihelical fold is over created, this means that the bend in the cartilage has been too exaggerated. This can not be simply improved in most cases by merely releasing the scar tissue between the two cartilage sides on the back of the ear. The cartilage has likely lost its original memory (exceeded the limits of elastoc deformation of the cartilage) and will not just spring back out after one year of healing. Instead the cartilage fold must be expanded and maintained by an interpositional cartilage graft, acting as an ‘internal spring’ so to speak. This small cartilage sping graft can usually be havested from the same ear from the backside of the conchal bowl. In the painful otoplasty ear, even if the result is good, the discomfort likely comes from one of two sources. A concha-mastoid suture may have been used to help with repositioning and, in stiff or thick ear cartilage, this may cause persistent pain or the perception of spasm. This suture can be released at this point. The other pain problem that I have seen is that stiff ear cartilages may be bettered weakened and repositioned by cartilage scoring or wedege resection rather than just using sutures to overcome their shape.
Dr. Barry Eppley