I am planning to undergo otoplasty to reduce the conchal bowl (i.e., to change the orientation of my ears from a prominent angle to one further back). I have consulted two surgeons, who each suggest using different approaches.
One surgeon suggests an approach that involves (among other things) resecting sections of cartilage from the conchal bowl. He suggests that this procedure is likely to be free of re-drift (i.e., ears folding out again), that the ears can be set at a natural angle (e.g., 15-20 degrees), but that there may be some difference in the angle on each side. The other surgeon suggested using permanent sutures (approx. 1 cm from base of ear) to pin the ears to the fascia of the skull. He suggests that this will help prevent re-drift (that he thinks is more likely when using only cartilage resection from the conchal bowl). He also says that using permanent sutures, the ears can only be positioned flat back against the head (rather than a more natural angle).
I respect the advice of both surgeons (who both appear to be competent and honest), but am confused by the conflicting opinions. What are the pros and cons of each approach? For example, how likely will complications (i.e., re-drift and/or asymmetry) using cartilage resection (i.e., without permanent sutures to the cranial fascia) occur? And could the permanent sutures be ripped (e.g., in contact sport etc.) or pulled through over time (e.g., as I age)? Thank you.
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February 6, 2014
Answer: The answer depends on how "set back" you want your ears.
It depends on the extent of correction involved. If it is a relatively short procedure, like reducing the length of the earlobe, then local anesthesia is sufficient and you would be awake. If it is more extensive, such as transferring cartilage to the ear, general anesthesia would be needed.
Minimizing Scars with Otoplasty
Scars and incision placement are an important part of otoplasty surgery. There are four basic approaches to otoplasty or correction of 'dumbo ears.' Experience of the surgeon influences results. The four types of surgery are as follows:
Conchomastoid sutures:...
Otoplasty recovery time is relatively quick. After correction has been achieved, a compressive head dressing is applied which encompasses the ears. The patient is discharged to home the same day as the procedure. The following day, the dressing is removed in the office. ...