Q: Dr. Eppley, I was wondering if you can preform an ear reduction surgery. My ears are very big (tall) and I would like them reduced in size. They have always been too big for my head and it has bothered me all of my life. I have done some imaging of ears to show my “desired” results, I understand that they might not be exactly attainable. Any information is greatly appreciated.
A: What you are demonstrating is vertical ear reduction. This is possible but not by the way you have imaged it. You have shown imaging where the upper third of the ear has been reduced which is an area of the ear that can not be reduced without disruption of the shape of the superior crus and helix which would give the ear an unusual shape…not to mention prominent scars. Vertical ear reduction must be done through the middle portion of the ear where the scars can be better hidden and the alignment of the outer helix and the antihelical fold can be preserved. Also that amount of vertical ear reduction is probably a little more than can be achieved.
Dr. Barry Eppley
Q: Dr. Eppley, I have recently seen photos of myself at many different angles refereeing basketball games and in family pictures. It made me come to the realization that I really do have rather large ears. I attached 3 pictures of myself to this email to illustrate. I looked on your webpage, and I see that you talk about a procedure that you do to pin ears back that stick out. Mine don’t stick out, I would just like to make them a little smaller. I did some research and found the procedure that I desire, which I copied below. Is this something that you could do for me?
A: What you are referring to is known as vertical ear reduction, or truly making a large ear smaller. Unlike a setback otoplasty, which is done by an incision on the back of the ear and pins the ear back, an actual ear reduction removes a wedge of skin and cartilage from the center of the ear. This shortens the total ear height 10 to 15mms. This is an old well known ear reconstruction technique more commonly used for the removal of skin cancer simply applied for the cosmetic concern of a vertically long earl While very effective a scar along the line of excision. The key to getting a good scar is to not make it a straight line as it crosses from the concha (bowl) of the inner ear across the antihelical and helical folds. Much like a broken line scar closure technique for scar revision, the interrupted and irregular closure line scars better.
Thus, it is not a question of whether it can be done but whether this fine line scar across the middle of the ear is a good trade-off.
Dr. Barry Eppley
Q: Dr. Eppley, I would like to reshape my chin. My chin doesn’t stick out, it just looks boxed look especially when I started losing weight. Also my ears don’t stick out, I feel they look big as in length for my small head. What do you recommend? I have a front and side picture for you to see.
A: Thank you for sending your excellent pictures. Your square chin can be contoured fairly simply through an intraoral approach where the square corners are removed (chin ostectomy) and the chin made more rounder as a result. The vertical height of your ears is a more challenging issue. It can be seen that what makes your ears long is that the upper half of the ear is big compared to the lower half. While they can be reduced substantially in height, this necessitates a scar which would run across the outer helix in the upper ear area. I am not so sure this is a good aesthetic trade-off. There is an alternative approach for ear height reduction that is done from behind the ear, which leaves no scar on the outside, but it would only reduce the height of the ear a minor amount. So you can see neither approach is ideal, substantial reduction with a scar or minimal reduction with no scar.
Dr. Barry Eppley