Conchal setback and sutures to pin back upper and lower ends of ears - is this a routine procedure? (Photo)

Question

I have prominent, outward rotated ears. I plan on getting a conchal setback to turn the ears inwards, but when I try this using my fingers, I find the upper and lower 1/3 of the ear pops out, giving that telephone look. When I meet my doctor again, I plan on also asking him to suture back the upper and lower ends onto the cartilage, bringing them back. Can I please have your opinion on if this is routine? Or do you normally only perform a conchal setback without worrying about the ends?

Bryson G. Richards, MD · Answer

Thank you for your question.Looks like you have been doing your homework. A conchal bowl setback is one component of an otoplasty. Most commonly the upper third of the helix protrudes and needs to be set back using permanent sutures in the cartilage. This can be performed through the same incision used for the conceal bowl setback. Often times, a section of the conchal cartilage needs to be removed in order to set the ear back.I hope this helps.- Dr. Bryson Richards

Stephen Weber MD, FACS · Answer

The majority of people with prominent ears will require both setback of the bowl of the ear as well as suture placement to set back and create the natural folds of the upper part of the ear. Additional sutures can be used to setback the lobule (earlobe) as well. Telephone ear is a post-surgical deformity that can usually be easily avoided with proper technique. All of these maneuvers are routine. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Tom J. Pousti, MD · Answer

Good for you! You are absolute correct in that the upper, middle, and lower parts of the ears should be set back in order to achieve an aesthetically pleasing result after otoplasty surgery. This procedure will typically involve more than just conchal set back; reconstruction of the anti-helical folds (superior ear) and set back of the ear lobules ( lower ears) are routinely performed during otoplasty surgery. Again, discuss your concerns with your plastic surgeon and make sure that you are both on the same page when it comes to goals, prior to proceeding.  Thank you again for the good question and best wishes for an outcome that you will be very pleased with.

Waldemar Merck, MD · Answer

In your case, the upper, middle and lower parts of your ears must be pinned closer to your head. This can be done with various surgical methods. On the one hand, there are numerous traditional methods; on the other hand, there is the minimally invasive stitch method which involves the least risks.

Peter Callan, MBBS, FRACS, MBA · Answer

Hi there.You are spot on with your description and almost always both conchal bowl resection and suture fixation are required.Have another chat with your surgeon as you were planning.

Conchal setback and sutures to pin back upper and lower ends of ears - is this a routine procedure? (Photo)

Answers (5)