Hard, Growing Bump on Ear After Otoplasty? (photo)

Question

My son had an otoplasty in 2010. At the post-op consultation, I inquired about a small bump on the top part of his ear where it met his head. It looked like one of the stitches was tied into a knot. The physician said it was swelling and would eventually heal. At first, the bump did shrink. About a year ago, we noticed the bump was getting larger and more protruding. It seems to be growing in size. What is this lump? Can this protrusion be removed? Will it take more surgery and anesthesia?

Michael I. Echavez, MD · Answer

It's difficult to give you a diagnosis without examining the lump on your son's ear. It's possible that it could be a keloid scar, but I can't be sure without seeing it. I would think that the only way it could be removed would be to excise it surgically. This would be a relatively minor procedure, and depending on your son's age, it could possibly be done in the office with just local anesthesia. Have you been back to see the surgeon who performed the otoplasty? That would be my recommendation.

Gary R. Culbertson, MD · Answer

The most common ear growth after an otoplasty in a caucasian patient would be a simple Epidermal Inclusion Cyst (EIC). They tend to change a bit with time and if squeezed extrude an often fowl smelling white cheesy material.  They are easily removed and rarely recur. The other issue as mentioned could be a Keloid. A keloid is a scar that grows out into normal tissue. They are often very difficult to illuminate. Consider returning to your surgeon for an evaluation and option. Best,

	 

	Gary R Culbertson, MD, FACS

Edward Farrior, MD · Answer

The bump at the superior margin of the incision on his ear appears to be a keloid. Keloid scars are scar tissue that grows beyond the bounds of the initial injury. The management of keloids typically includes surgical excision and the injection of steroids to prevent inflammation during the healing process. In keloids that recur after excision and steroid injection a single dose of postoperative radiation therapy optimizes the chances for curing, or no recurrence, of the keloid. The dose is administered only once and is very low carrying almost no risk whatsoever. I would recommend excision with steroid injections first. I do not believe steroid injections alone will achieve resolution.

Moneer Jaibaji, MD · Answer

Thank you for the question. The bump could a keloid scar or an inclusion cyst. If it is a keloid then the treatment is excision and steroid injection. If the lesion is an inclusion cyst then simple excision is all that is needed. Both procedures mean another surgery. Good luck.

Tom J. Pousti, MD · Answer

Thank you for the question and picture.

	 The area of concern does look like a keloid scar, possibly associated with an underlying suture ( based on your  description of events).  I would suggest that you follow up with your plastic surgeon and discuss treatment options, which may include excision and/or the use of steroid injections.

	 Best wishes.

Hard, Growing Bump on Ear After Otoplasty? (photo)

Answers (5)