Your Questions
Your Questions
Q: Dr. Eppley, I just recieved otoplasty and earlobe reduction one month ago.I The surgeon did a wonderful job thus far but there is still some minor sweeping and obviously the ears will change shape a bit over next few months. However I don’t believe enough length was removed from the earlobes. My ears still feel long and large. (not protruding) I’ve been through multiple of your surgery photos and reviews and honestly love what you do with the ear anatomy. What I would like to know is if you could take an additional amount from my earlobe to sort of shorten the ear. I would love to do my revision with you. Please let me know if and when and I have attached pictures for your review. I would love to get out opinion. Thank you for your time and I look forward to hearing from you.
A: Earlobe reduction can be done at the same time as an otoplasty or any time afterwards. The blood supply to the earlobe is not affected by any type of otoplasty procedure or even a prior earlobe reduction. The best vertical earlobe reduction technique is the helical rim type which places no visible scar on the outer surface of the earlobe. You probably need another 5 to 7mms vertical reduction. I can not completely tell from your pictures as to what type of earlobe reduction you had done but it does not appear to be of the helical rim variety. Regardless another earlobe reduction can be still be done.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I have low set tilted back ears. I want to know if it is possible to bring the ears forward, thus raising the top vertically? In other words, is it possible to rotate the right ear clockwise, the left ear counterclockwise; thus, rotating the top of the ear forward. I obviously do not know anything about this, but it would seem that the rotation would result in the top of the ear being ‘higher up’ five millimeters or more depending on what is possible. I understand the canal cannot move upwards. If this is possible, how much vertical increase in the top of the ear would result from the forward rotation? Is it possible to rotate them forward so that the top of the ear is the eyebrow level without relapse?
I also desire the lobes to be shortened and the ears pinned so they do not stick out so much. Attached at the bottom are pictures. Lastly, if this is possible, is this an otoplasty procedure that you perform? Thank you for your time and consideration.
A: I have done numerous ear lifting type otoplasty procedures, some with moderate success and some with little vertical change at all. You are correct in your assessment that the fixed point of the cartilaginous ear is the canal which prevents any significant cartilage relocation. Whether the upper half of the ear can be moved upward at all this depends on the flexibility of the superior helix. Any lifting effect at all comes from relocating the area behind the anterior crus of the helix upward. By suturing this cartilage area up higher on the temporal bone with microscrew fixation, some vertical lengthening of the upper ear can be achieved. That effect can be maximized with setback of the upper helix since this also can cause a rotation effect if desired and appropriately sutured. Putting the two together can help raise the vertical height of the ear but not to the level of the eyebrow however. A vertical reduction of the earlobe will also help not only shortening the vertical length of the ear but may also help create the illusion that is actually higher.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I am interested in some facial reshaping procedures. I am 54 and desire more of a heart shape to my face. It is long and not as feminine as I would like. My nose is a bit long and wide on the bridge (from the front esp.) Looking younger would be great, but looking more feminine and therefore prettier is my main goal. Wider temple area/distinct cheekbones, tighter jaw to neck angle, more of a right angle beneath chin-to-neck, and a feminine nose are some ideas I have. My jawbone has reabsorbed somewhat, according to my dentist. But I need YOUR trained eye to tell me how to accomplish my goal of looking more feminine, losing the chub underneath my chin, creating a prettier facial shape in general. Thanks so much for giving me the straight scoop.
A: In looking at your pictures and understanding your facial reshaping goals, I would recommend the following changes.
CHIN A V or triangular shaped chin implant augmentation with the objective or bringing your chin forward, which is short, but making it narrower at the same time.
NOSE An open rhinoplasty to narrow the nose from the bridge to the tip with some slight shortening and elevation of the tip with nostril narrowing.
CHEEKS Cheek implants that produce some a combined malar/submalar (shell) effect. This with the chin helps create more of a heart-shaped face.
TEMPLES Subfascial temporal implant to correct the hollowing and increase the bitemporal width.
EARLOBES I know you did not mention these but these seem a little bit and stick out and reducing them adds a touch of femininity to the sides of the face.
I have attached some computer imaging predictions of how I see these changes affecting your face.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I have two questions. Do you do permanent eyebrow shaping and coloring? How often does one have this procedure done? What is the fee? What is the cost of earlobe repair as my hair is short now and I have worn heavy earrings making my lobes longer.
A: Thank you for your inquiry. What you are referring to is known as permanent makeup or micropigmentation. It is done for the creation or restoration of eyebrows regularly. I have a fully trained and certified aesthetician who is our micropigmentation specialist. This is done in the office under local anesthesia and takes a few hours to complete. I will have her contact you to provide the costs of the procedure. It is important beforehand to have a consultation where the eyebrow shape and color can be selected. Usually we like to apply with an eyeliner pencil the shape of the eyebrow and color so you may wear it for a few days to be certain it is right for you. Micropigmentation, like many tattoos, can be difficult to reverse and it is best to think of this procedure as irreversible.
Earlobe repair/shortening is also an office procedure done under local anesthesia. So combining earlobe reduction and eyebrow procedures would be a convenient approach to solving both concerns in but a few hours. Neither one is associated with any recovery issues.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I have large earlobes and I want to get them reduced. I have always had them since I was child. I was constantly teased about them even by my parents and it has bothered me deeply ever since. They simply don’t fit with the rest of my ear. They are big, floppy and hang down. I am now 45 years old and have decided it is time to finally do something about it. How is earlobe reduction surgery done? What is the recovery and is the scarring bad?
A: The earlobe is uniquely different than the rest of the ear since it does not contain any cartilage. It can become big either by genetics (as in your case) or from becoming stretched over time by ear ring wear and gravity. Either way, earlobe reduction is a fairly simple surgery that canbe done under local anesthesia in the office. The earlobe is cut down in size by removing a central wedge of tissue, reducing both its height and width. Usual reduction is around 50%. There are no dressings used and the tiny sutures on the outside of the earlobe are removed one week later. You can shower and wash your hair the very next day. Scars on the earlobes heal so well that three months after surgery that are undetectable.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I have two large earlobes and would like for them to be smaller. They seem to be getting bigger as I get older. I am now 57 years of age and I don’t think they were this big when I was younger. Do earlobes grow as one ages? I am also wondering about the cost for this type of earlobe surgery. Could I get an estimate and would any permanent scars result from it? Also how long does it take to heal or until I can take the bandages off? Thank you very much for your time.
A: Earlobes do in fact grow with age somewhat although not in the classic sense of growth. They do not grow anymore than your sagging jowls and neck grows. Rather it is an elongation process where the tissues stretch due to gravity and ear ring wear. As the earlobe is the only part of the ear that does not contain cartilage, the skin and fat has no resistant internal structure. Earlobe reduction is an office procedure done under local anesthesia. There are different earlobe reduction techniques that vary only in where the final scars are located. The scar locations can be down the central area of the earlobe, at the junction of the earlobe and the face, and along the bottom rim of the earlobe. Which one is best depends on the shape of your earlobe and where you would prefer the scar. There really is no recovery after this procedure nor are they any bandages used afterwards.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I would like to get my ears reshaped. I think they are too big at the earlobes and they stick out a bit. My earlobes seem too big for a younger male and I have always been self-conscious about how my ears stick out. Can my ears be pinned back and the earlobes reduced in size at the same surgery? I haved attached some pictures of me from the front so you can see what I mean. It is hard to look at anything else but my ears in these pictures!
A: Thank you for sending your pictures. I can see your concerns about earlobe reduction and a little bit of ear pinning. The combination of the two would solve those concerns and make your ears blend in naturally along the side of your head. Ears should blend into the side of the face and not be a dominant facial feature. The ear can be put back a little further by adjustment of the concha through mastoid sutures from an incision on the backside on the backside of the ear. The earlobe can be reduced by half its current size. The only question there is scar location. There are three different methods of earlobe reduction with changing locations of the scar. Regardless of how earlobe reduction is done, it can be combined with ear pinning (otoplasty) at the same time and are fairly easy to undergo. There is really no significant recovery other than some slight external ear swelling.
Dr. Barry Eppley
Indianapolis, Indiana