Michael Bermant, MD (retired)

Earlobe reduction can be done alone, as part of an otoplasty ear surgery, or as part of a Macrotia Ear Reduction Sculpture. Options depend on the problem to be treated.

A simple ear reduction can be done under local anesthesia. More involved problems I prefer using local with sedation for patient comfort and safety.

There are many different problems that all can be called "big earlobes" and the surgery is best individualized not only for each patient, but also for each earlobe. I prefer to hide the earlobe reduction incisions as much as possible.

Hope this helps.

Yes, one sided otoplasty is possible. You can see examples I and others have done on the web by searching Google for "one sided otoplasty." Options depend on the problem to be treated.

When only one ear is deformed, surgery can sculpt that ear alone. However, when the other ear is also deformed, matching the worse ear to a less deformed ear can be quite difficult.

Such issues are best explored during a consultation.

Hope this helps.

I prefer the open technique that permits me to use multiple sculpting tools to balance the various elements of a patient's ear during my ear sculpture. This open technique features minimal swelling and bruising that I can demonstrate with early after surgery pictures.

The "incisionless" otoplasty is a marketing hype that actually involves several small incisions. The antihelix fold is then bent with sutures. Fine if the ear problem is only a flat antihelix fold. Some claim that there is less bruising and swelling after surgery, but try to find early after surgery pictures with that technique.

Most patients' ear problems have various components contributing to the deformity. An "open" otoplasty gives the surgeon access to the structues to be shaped from incisions that hide very well. We can blend contouring techniques to better shape the ear. The skin can then redrape over the new ear.

Try to find many before and after surgery pictures from that doctor and his / her technique. With good otoplasty, the ear should look natural with the different elements blending together. The helix rim should just barely show from the front.

Carefully look at the results of the "incisionless" operation. Too often there is an Over Folded Antihelix that tries to compensate for other problems. The helix rim is often hidden behind the ear when looking from the front.

Hope this helps.

Recovery after ear surgery depends on the problem to be treated, what was done, the skill of you doctor, after surgery care, ear dressing, and other factors best discussed during a consultation. My patients are up and about the day of surgery. Bouncing, bending the head down below the level of the heart, and vigerous activities evolve over time. Patients are usually back to light work the week of surgery. Comfort is the guide nature provides as to what the body can do.

Start by Minimizing Swelling and Bruising
I prefer techniques with minimial swelling and bruising. This is something best demonstrated with pictures at different times after surgery showing the evolution of tissues. Choosing a doctor who shows such pictures will give you a better idea of the typical problem that doctor's sculpture creates.

Continue with Ear Protection
A formal ear dressing after surgery helps protect the ears early after surgery. How long depends on what was done. For a normal ear pinback, this dressing is needed for 1-5 days after surgery. We typically change this dressing the day after surgery and every other day until it is not needed. For some patient, I then use a head band to protect the ears when sleeping. When done right, the maximum swelling occurs the day of surgery.

Patient Education Key
A well informed patient is key to a quick recovery. That is why for our patients we put so much information on the web so they can better understand what surgery offers, limitations after surgery, and other details to make their recovery easier.

Hope this helps.

Most patients who complain about big ears that stick out have normal size ears that project away from the head. Some actually have big ears (Macrotia) that can either stick out or lie against the head.

What makes an ear sticks out can vary from patient to patient. Individual elements or a combination of elements can contribute to the problem.

• A flat antihelix fold
• Concha Bowl angles out
• Large Concha Bowl
• Other components