Q: Dr. Eppley, I am looking for an otoplasty reversal surgeon who can offer the best possible result for an undesirable otoplasty result in my left ear so. I have attached a picture showing my ear before the otoplasty and a second picture where i had undergone a revision where the sutures and scar tissue was removed in the hope the ear would look how it was before. It shows the antihelix being thick and overfolded in the lower part and the upper part has lost roundness. I appreciate my ear will never look the same as before I had the original procedure but what are your experiences in an antihelix deformity such as this and do you feel you could make a significant difference using any type of revision (cartilage/skin graft, scar release etc).
Thank you for taking the time to read this and I look forward to your response.
A: Thank you for sending your pictures which are very helpful in showing the otoplasty problem. This appears to be an overfolding of the helix, causing a deformity of the antihelix which lies in front of it. The correction would obviously lie in reversing how the otoplasty was done…getting the helical rim to unfold back out. This will not be achieved by releasing any tissues alone as the cartilage is now ‘deformed‘ and has a new shape. The release must be supported by an interpositional graft of which I have used cadaveric rib/bone and the patient’s own small rib graft to achieve a stable otoplasty reversal result. In my experience, this graft technique is essential for the procedure’s success as you have learned that releasing the scar/sutures alone is unsuccessful. (unless it is done within a few weeks/months after the procedure)
Dr. Barry Eppley