Left Ear Reconstruction after Graft Harvest

Q: Dr. Eppley, I had a graft taken from my left ear for nose reconstruction. While the left ear has healed well, it has left it deformed now being smaller and more bent in. Can anything be done to make it look more normal again. I have attached pictures comparing my left versus right ears.

A: Thank you for sending your ear pictures. You appear to have originally had a full thickness chondrocutaneous graft harvested from the root of the superior helical attachment of the left ear. This will create a expected vertical shortening of the height of the ear when it is put back together. While recreating that defect by reopening it and grafting it with a full thickness chondrocutaneous graft from the opposite ear is what ideally is needed for your ear reconstruction, the combination of creating a patch look to the reconstructed side and a similar defect on the other ear makes that approach completely undesirable/unacceptable.

Another ear reconstuction option is to add more vertical height to the superior helix just above the defect through either a small chondrocutaneous graft taken from the back of the normal ear which will leave no defect in its wake. Releasing the skin on the back of the helix and placing the graft from behind will raise up the height of the shortened superior helix to give the ear a more normal helical root appearance. The other option is to place a small cartilage graft our even a tubular implant under the helical rim skin to give it more height.

Dr. Barry Eppley
Indianapolis, Indiana