I have seen 3 surgeons and they all suggested different techniques. The 1st one recommended "shaving" the conchal cartilage to weaken it, the 2nd preferred doing small incissions on the cartilage instead of making a cut and the 3rd one said its best to remove a small portion of the concha in order to get long lasting results. All of them suggested Mustarde sutures to pin the ear back. Can someone please advise on the pros and cons of these approaches? Thank you from the bottom of my heart.
October 28, 2018
Answer: Multiple ways for otoplasty There are a number of ways to perform otoplasty. I would look less at the method of achieving the result than the result itself. You have to be comfortable with the confidence of your surgeon and the results he/she is able to achieve on previous patients.
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October 28, 2018
Answer: Multiple ways for otoplasty There are a number of ways to perform otoplasty. I would look less at the method of achieving the result than the result itself. You have to be comfortable with the confidence of your surgeon and the results he/she is able to achieve on previous patients.
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October 28, 2018
Answer: Otoplasty techniques - an explanation Good results are possible with various techniques. An experienced surgeon will usually get the best results using the technique/s with which they are most familiar or use regularly. I advise you check with your surgeon about their experience with otoplasty and see a suitably qualified and experienced plastic surgeon. Ask them about their revision rates. Here is an explanation of techniques for surgical otoplasty that I use or have used.Mustard suturesThese are used to make or increase the folding of the anti-helical fold. A flat or under folded anti-helical fold is one of the most common reasons for prominent ears. This is often combined with something to weaken the cartilage to resist it springing back. This could be by thinning, making cuts in it or my preference is to bipolar diathermy (electrocauterise) the back of the cartilage which tends to make it fold and then stay folded (this can be called a thermo-chondro-plasty which I learn't from the late Don McNeil at Odstock, Salisbury, UK many years ago).Conchal cartilage excisionAn alternative technique or complimentary approach addresses the problem of an enlarged conchal cartilage. This may be the cause of prominent ears on its own or in combination with a flat anti-helical fold. If the cause is only a large conchal cartilage then removing a crescent of cartilage from the conchal bowl can be an excellent technique on its own for correcting a prominent ear.Anterior scorring technique (Chong Chet method)This is also an excellent method which I used extensively in the past. I never had a serious problem with it but I consider it to be a riskier method due to the potential for bleeding under the skin resulting in a hematoma which if infected can result in a very badly deformed ear. In view of this risk and in the face of alternatives (above) I elected to stop using it routinely. It is however, a technique with which I produced many happy patients in the past. It was only after speaking with an ear reconstruction specialist (David Gault, London) about his experiences with complications of this technique that I decided there were safer ways of producing equivalent results.In practice I most often use Mustard sutures and not infrequently with a conchal excision. Least often I will just do a conchal excision.I hope my perspective does not simply add a 4th 'opinion'! but perhaps helps you to understand some of the different approaches to otoplasty.Best wishes
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October 28, 2018
Answer: Otoplasty techniques - an explanation Good results are possible with various techniques. An experienced surgeon will usually get the best results using the technique/s with which they are most familiar or use regularly. I advise you check with your surgeon about their experience with otoplasty and see a suitably qualified and experienced plastic surgeon. Ask them about their revision rates. Here is an explanation of techniques for surgical otoplasty that I use or have used.Mustard suturesThese are used to make or increase the folding of the anti-helical fold. A flat or under folded anti-helical fold is one of the most common reasons for prominent ears. This is often combined with something to weaken the cartilage to resist it springing back. This could be by thinning, making cuts in it or my preference is to bipolar diathermy (electrocauterise) the back of the cartilage which tends to make it fold and then stay folded (this can be called a thermo-chondro-plasty which I learn't from the late Don McNeil at Odstock, Salisbury, UK many years ago).Conchal cartilage excisionAn alternative technique or complimentary approach addresses the problem of an enlarged conchal cartilage. This may be the cause of prominent ears on its own or in combination with a flat anti-helical fold. If the cause is only a large conchal cartilage then removing a crescent of cartilage from the conchal bowl can be an excellent technique on its own for correcting a prominent ear.Anterior scorring technique (Chong Chet method)This is also an excellent method which I used extensively in the past. I never had a serious problem with it but I consider it to be a riskier method due to the potential for bleeding under the skin resulting in a hematoma which if infected can result in a very badly deformed ear. In view of this risk and in the face of alternatives (above) I elected to stop using it routinely. It is however, a technique with which I produced many happy patients in the past. It was only after speaking with an ear reconstruction specialist (David Gault, London) about his experiences with complications of this technique that I decided there were safer ways of producing equivalent results.In practice I most often use Mustard sutures and not infrequently with a conchal excision. Least often I will just do a conchal excision.I hope my perspective does not simply add a 4th 'opinion'! but perhaps helps you to understand some of the different approaches to otoplasty.Best wishes
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