Do I Need Rib Cartilage For My Left Ear Reconstruction?

Q: Dr. Eppley, I am interested in having an otoplasty on my left ear. While I did not find many of these types of surgeries during my research, I would like to ask you a few questions.Have you performed similar surgeries in the past, and if so, could you please send me some before and after photos?

What type of method do you plan to apply for this type of surgery and where will the scars be located? Will I have a small scar on the helix of my ear?

I was thinking about a reconstruction from the upper middle up to the top of the ear with the use of a cartilage graft for support, as I saw in one of your surgeries. Do you think that is the best technique to apply on my ear?

A: Thank you for your inquiry and seeding your pictures. You have a form of a constricted ear as seen by the folded over helix from the middle of the ear (3:00 position) up to the center of the top of the ear. (12:00 position) While some may refer to it as a Stahl’s ear, because of its pointed appearance, it does not have a third crus so it is not a classic case of it. The helix is also setback behind the antihelical fold as part of the overall hypoplasia. Interestingly some helical cartilage can be seen protruding from behind the helical skin almost as if the cartilage is adequate by the skin is deficient.

But I do think that the skin needs more helical cartilage support to both pull the helical rim skin back over it as well as provide some more projection. As you have noted a cartilage graft is needed to do so an the right amount and curve to it comes from a small portion of the subcostal rib #9 or #10.

Dr. Barry Eppley

Indianapolis, Indiana