The correction of protruding ears has been done by a variety of procedures over the years, from cutting out skin on the bck of the ear, removing cartilage, and cartilage suturing techniques. Over the years, it has been learned that the removal of skin and cartilage is unnecessary as the problem is not tissue excess, but the shape of the cartilage. Specifically, the shape or absence of shape of the antihelical fold is the problem. Creating the antihelical fold through the use of cartilage sutures on the backside of the ear creates a very natural-looking ear result and should match what one can achieve by folding the ears back with one’s fingers.
This relatively simple procedure is done as an outpatient procedure that generally takes one hour or less to perform on both ears. By making an incision on the back the ear, the cartilage can be reshaped by a suture technique. Sometimes it is necessary to take some skin from the back of the earlobe to get it to fall in line with the shape of the rest of the ear. But this is not always necessary. The ear effect created is immediate and dramatic. In adults, I have them wear a headband to protect the ear for a few days but they can shower the next day and have no fear about gettiing it wet. In children, I ‘childproof’ the ears by a bigger head dressing that stays on for around five days and then they wear a headband after for protection.
The key to a good-looking otoplasty result is that the new ear position must be natural-looking. Overdone ears which are pulled back too far are unnatural and are known as the ‘telephone-ear’ deformity. This problem is difficult to correct unless the patient returns to the oeprating room within a few weeks after surgery.
Otoplasty is a very gratifying operation that has few complications. Beyond the immediate risks of infection or poor correction (which I have not yet seen), the only long-term issue is that the permanent sutures used may eventually come through on the back of the ear. This is a minor problem that is solved in the office. It is very pleasing to see such a simple operation that has such dramatic lifelong self-image benefits.
Dr. Barry Eppley
Indianapolis, Indiana