Q: Dr. Eppley, I am interested in revision of an otoplasty reversal procedure that I had just a few weeks ago. I had an otoplasty twenty years ago where the ears were over corrected and pulled back too far. I had an otoplasty reversal done two weeks ago to project the ears further out from my head. When i left the doctors office they looked great but with in five days the results were back to the same as before surgery and is still changing. Is there anything i can do to correct and regain the result of a few weeks ago. What my options? Thank you.
A: In otoplasty reversal surgery for the classic telephone ear deformity that you have, the key surgical maneuver is to place an interpositional spacer or graft once the overfolded ear cartilage is released. If this is not done the procedure will not work. It may look good for a few days because of swelling and the local anesthetic injected into it but cartilage release alone will return quite quickly back to where you started. That will only work if the otoplasty is new and within a few months after the initial surgery. Once the cartilage is released something must hold it out to occupy the open space between the ear folds to not only overcome the ear cartilage memory but to prevent scar contracture pulling the ear right back into the overfolded position. I have used a lot of different material for the procedures but my current favorite is irradiated homologous rib graft. It is very sturdy and avoids any rib graft harvest from the patient.
Dr. Barry Eppley