I had otoplasty on both ears several months ago. The technique used was standard mustarde stitches, no scoring of cartilage or skin removal. An infection in my left ear sharpened the antihelical fold in the middle and pulled it in a few mm more than the right ear. My doctor intends to put a few more sutures in the right ear and remove some skin, which he thinks will bring it in closer like the left one. Does removing skin create a sharper fold or do I need something like scoring of cartilage?
Otoplasty Revision - Need Advice?
Doctor Answers (3)
Otoplasty: Scoring Cartilage, Sutures, Skin Excision? What Works Best?
Traditionally otoplasty combines Mustarde sutures to create a sharper antihelical fold and conchal setback (Furnas sutures) to reduce an overly prominent bowl of the ear, or concha. Scoring on the lateral side to help soften the cartilage of the antihelix has become more popular recently, but in my experience is rarely needed. Skin excision alone is often counter-productive unless there is excess skin (created during the conchal setback). Removing normal skin can create tension and wide, thick scars. However, your surgeon already knows all this. He has the luxury of having examined you, so trust him to help you make the right decision.
Usually skin excision alone is not enough to change and maintain the projection of an ear. Scoring of the cartilage is often needed to reduce the tension of the cartilage and help maintain the correction since skin excision alone can stretch over time.
Need photos to give you some tailored good advice. In general, it is almost always helpful to score the cartilage on the opposite side of wherever one wants the cartilage to bend. This releases the tension on that side and therefore the holding sutures on the more acute side of the bend are much more likely to hold longterm.
It sounds like scoring the right antihelical fold in front would be of benefit, along with tighter holding sutures. I also tend to remove some skin, but I don't think it is as important as the the other maneuvers.