Undercorrection otoplasty or just swelling?(photo)

Thank you for your question. You had an otoplasty two months ago, and you feel like your ears are still sticking out too much. You feel your earlobes were not set back properly and are still prominent, but your doctor said that nothing can be done about the earlobes. You’re wondering if it’s just under correction or if it’s due to swelling. I can certainly help you with this concern of yours. I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon, practicing in Manhattan and Long Island for over 20 years. Otoplasty is part of what we do in our daily practice. The anatomy and concept of otoplasty is relatively straightforward, however the execution and achievement can sometimes be a little tricky. When it comes to the procedure itself, think of it in terms of thirds — the upper third of the ear, the middle third, and the lower third; and then upper third cartilage, the middle third cartilage, and the lower third which is most of the earlobe. All these need to be taken in by just the right amount and with maximal symmetry. People whose ears stick out significantly often come to us saying they want them very close to their head, as if to compensate for this. We always use the one centimeter rule as a guideline when it comes to the distance of ear relative to the skull or to the bone, as dictated by medical literature.In your case, what you show in your photos — the earlobe being pushed inward — clearly doesn’t look natural. However, the way the ears look seems relatively symmetric and they don’t look like they are protruding significantly.There is obviously a communication issue between you and your surgeon, as it seems that you could not come to terms on the degree at which the ear should be brought in, or what would be ideal. The earlobe can potentially stick out after the upper third and middle third of the ear are brought in, and this can be corrected with surgery, which can be done at the same time as an otoplasty surgery.In the two months since your surgery, I wouldn’t necessarily say that swelling is a factor in terms of the significance and the relative protrusion of your ears, however, you could benefit from allowing any swelling to resolve first before pursuing revision surgery.I recommend that you meet with your surgeon and discuss your concerns very carefully. Keep in mind that there are different methods of performing otoplasty, and you need to clarify this with your surgeon. Take a look at your before and after photos and decide how many millimeters is worth another surgery. Also, remember that the human body is intrinsically imperfect and asymmetrical — in fact, one of the phrases we use in our field is “the enemy of a good result is a perfect result”.Ultimately, yes, based on your photos, it seems that you can set your ears back further, however you and your doctor must analyze whether it will look good enough to justify the surgery.I hope that was helpful and I wish you the best of luck!This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.

The lower portion of the ear can certainly be brought closer to the scalp with help of a revision otoplasty.RegardsDr. J

Your earlobes could be revised during the otoplasty or even after the surgery a few months later.    It could be done under local anesthesia at a later date if needed.     Talk to your surgeon and discuss your concerns.   if he is not comfortable you may need to find another surgeon in your area.