How Can My Cauliflower Ear Be Fixed?

Q: Dr. Eppley, I’m hoping you can fix my ear. I have hardened cartilage on my left ear that has caused my helix to flatten. I am hoping you can shave/remove the hardened cartilage and return my ear to it’s original shape.

A: I am going to assume that the hardened cartilage in your left ear is from some form of trauma. Perichondrial sheering and hematomas can cause cartilage to grow and thicken the natural ear cartilage resulting in loss of the normally concave portions of the ear and/or making the convex areas even bigger. This is classically seen in the ‘cauliflower ear’ with varying presentations from smaller areas like yours to those that can even involve the entire ear cartilage.

You are correct is assuming that the hardened or thickened cartilage must be thinned down so that the helix fold can be recreated in an ear reconstruction procedure. This is done by raising the skin over the thickened area and shaving down the cartilage with a scalpel or dermal punches. Whether skin flaps must be raised on both sides of the ear to create adequate cartilage reduction can not be determined by a picture alone. The real key to this surgery is to ensure that a recurrent hematoma or fluid collection does not occur after surgery beneath the raised skin flaps as that will cause the same problem to recur. This is done by a combination of through and through resorbable sutures with a xeroform bolster dressing.

Dr. Barry Eppley

Indianapolis, Indiana