Can My Ears That Have Had An Otoplasty Be Partially Reversed To Bring Them Back Out Slightly?

Q: Dr. Eppley, I underwent otoplasty done over ten years ago with a pretty good result. But I have felt ever since that the corrections on the ears were too pronounced, particularly on the left which now has a largely hidden helix.  The technique used consisted of some skin removal on the back of the ear, weakening of the cartilage on its anterior surface and absorbable sutures used to create the fold. (from operative note from the procedure) The only scarring discernible to my touch is at the bottom of the antihelix and it is this scarring which seems to act as anchor for the over corrected folds. I have read that once scars have set several months post-op the ears become difficult/impossible to un-correct.  Nonetheless, I am emailing you my details to see whether you think my ears might have some potential for improvement and whether you think you might be able to help me with that improvement. My ears, apart from the scars, feel supple and flexible (perhaps because I’ve got in the habit of massaging them whilst pondering their post surgical shape and potential for improvement). I hope for only a subtle improvement, perhaps only noticeable to me, and would be keen to explore options or ideas which feature the least amount of invasiveness and slicing possible.

A:  You are correct in your assumption that ears that have undergone otoplasty surgery are difficult to undo, meaning to bring the ear back out. This is due to the long-established fold in the cartilage and the scar surrounding it. While it is difficult that does not mean that it is impossible. Since your goal is a ‘subtle one, perhaps a few millimeters, to bring the helix out from behind the antihelical margin, there is one approach that can be effective. Releasing the scar between the folds, scoring the cartilage and the placement of a small cross-beam cartilage graft (harvested from the concha right below the release) between the folds can bring the helix back out a little bit. This sounds complicated but it is not and can be done through just a portion of your old post-auricular incision.

Dr. Barry Eppley
Indianapolis, Indiana