What Technique Is Best For A Vertical Reduction Otoplasty For The Top Of The Ear?
Q: Dr. Eppley, I am interested in a reduction otoplasty. The height of my ears is too tall for my head/face. I have talked to several plastic surgeons about ear reduction and they all say that it can’t be done without severe ear distortions and scarring, which is very disappointing to me. Like I said I have been to a few surgeons who specialize in otoplasty and what bothers me is mostly the top portion. I have found only one surgeon who has pictures of this procedure, unfortunately he is retired. Do you know of anyone who would be able to preform this? Thank you so much for your time, it is greatly appreciated.
A: The traditional method of vertical otoplasty reduction, through a wedge technique, would result in significant upper ear deformation. What you are demonstrating is a different technique, known as a helical flap method, which can reduce the upper 1/3 of the ear without such deformations. It is actually a technique borrowed from ear reconstruction from the resection of skin cancers in the upper helical rim which is a common location of such cancers. That would be the technique of choice when it is the upper ear that is the source of the vertically long ear. It places the incision/scar line at he favorable location of the underside of the crus and the junction of the helical root rather than directly across the helical rim at a 90 degree angle. It would reduce the height of the ear by 8 to 10mms which is a noticeable amount.
Dr. Barry Eppley