3 Months Post-Op Ear Pinning, Left Ear is Protruding More than the Right, is a Revision Needed?

My 8 year old daughter had her ears pinned three months ago and now the left ear appears to be protruding more than the right. Before surgery it protruded significantly more than the right ear. The right ear looks like it did after But the left does not. Will she need another ear pinning for the left ear? How can it be done to be permant this time?

Doctor Answers 6

Otoplasty asymmetry after 3 months

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At 3 months you probably have 70% of the healing done. It may not change the outcome but you may want to wait for a full 6 months before considering a revision. You should know that asymmetry is normal and not all ears are alike in the normal population. Ultimately, you will have to decide if a revision is worth correcting the amount of asymmetry that is present. You preferences are the most important no matter that asymmetry is normally found in the population.

Bellevue Facial Plastic Surgeon

Otoplasty Meaurements

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In the normal population, the variability between the ears is about 4mm - that is the normal variation in nature from ear to ear in about 4mm.

After otoplasty, I try to keep the variation from side to side within 2mm. But if the variation is more than 4mm and is noticeable, revision surgery may be needed.

The good news is that the correction would usually fix the difference. Young children can have strong, resilient cartilage, so this can happen.

Edward Szachowicz, MD, PhD
Minneapolis Facial Plastic Surgeon
4.6 out of 5 stars 14 reviews

Revision otoplasty

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Asymmetry of the ears is common but you are questioning another issue and that is whether the suture holding the ear back could have loosened or broken. The answer is that can happen for a variety or confluence of reasons by no fault of the surgeon or your daughter. In that case, a revision would be necessary to re-pin the ear. You should discuss this with the plastic surgeon and, given you daughter's age, plan from there. You may need to give everything a bit more time to settle down before reoperating to assess final projection of the "good" ear.

Ear Asymmetry after Otoplasty

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Thank you for the question.

Whether your daughter will need revisionary surgery depends on the degree of asymmetry that is present and whether it concerns her and/or you. Keep in mind that it is likely that the ears will never be absolutely symmetrical (and that the casual observer never looks at both ears at the same time).

I would suggest follow-up with your plastic surgeon to address questions and concerns.  Permanency of correction  of the setback cannot be guaranteed if revisionary surgery is performed.

I would start by asking your daughter if she has any concerns about her ears  and follow-up with her plastic surgeon if necessary.

Best wishes.

Need For Revisional Surgery After Otoplasty

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The long-term results of otoplasty surgery depend on the stability and healing of the sutures that are holding the ear cartilages in their new shape. Between swelling and tissue relaxation it can take up to six months after surgery to see the final result and the symmetry between the two ears. Perfect symmetry between the two ears in otoplasty does not always occur and about 5% to 10% of patients may desire some minor touchups to improve their shape and symmetry. In the case of one ear that still sticks out further than the other, this may require a revision to place another suture or two or to remove a little conchal cartilage to get the ear back into a better position.

Asymmetry after Otoplasty for Protruding Ears

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Asymmetry or unequal appearence of the ears after otoplasty for protruding ear can occur for a variety of reasons.  

Sometimes the ears are asymmetrical before surgery and, therefore,  it may not be possible to make them perfectly symetrical.  

Allthough symmetrical at the conclusion of the otoplasty procedure, sometimes the ears may be pulled by the patient, or folded during sleep causing some of the stiches to tear trhough the cartilage, or break.  To reduce the chnce of this happening I use protective hed dressing  for a week and then a sports sweat band to hold the ears in place and protect them from being pulled.

The right ear may need to be redone if the asymmetry and protruding orf the ear is as signifcant as you describe.

Fredrick A. Valauri, MD
New York Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.