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?
3 Months Post-Op Ear Pinning, Left Ear is Protruding More than the Right, is a Revision Needed?
Doctor Answers 6
Otoplasty asymmetry after 3 months
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.
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.
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Ear Asymmetry after Otoplasty
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.
Need For Revisional Surgery After Otoplasty
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
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.