Cartilage Ear Scars After Otoplasty

I had otoplasty performed for protruding ears years ago. I am left with cartilage "scars" on both anterior antihelixes. On the left, the antihelix fold is so sharply bent that the overlying skin appears white. On the right there are small nodules on the antihelix fold. Incisions and sutures were done posteriorly so I am not sure how this happened? What can be done? The surgery was done 15 years ago.

Doctor Answers 5

Options for revision otoplasty

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If it has been many years since the original otoplasty, the sharp edges can be contoured with an anterior approach and shaving of the sharp edges. In regards to the nodules, these are most commonly sutures that need to be removed; some are easier to remove than others.

Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Otoplasty Correction Difficult When Cartilage Cut

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Otoplasty when done properly works great with a success rate well above 90%.  Sadly, some surgeons don't understand that you should never cut the cartilage to create the folds of the antihelix.  Once cartilage is cut like this, it can never truly be corrected.  It is possible that a revision surgery with smoothing of the edges and grafts over the cut edges could soften the unnatural crease and return it to something closer to normal.  This is a very customized procedure and must be discussed face to face with your surgeon to determine what might be possible in your case.

Louis W. Apostolakis, MD
Austin Facial Plastic Surgeon
4.8 out of 5 stars 37 reviews

Simple fix for unsightly results after remote otoplasty

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In addition to Dr. Young's insightful comments, I would add that I have seen "old" otoplasty deformities corrected quite simply with direct incision overlying the crease and nodules, and then excision of the sharp cartilage edges. The incision on the ear heals beautifully, and often the sharp crease and nodules are gone too! Good luck.

Randolph Capone, MD, FACS
Baltimore Facial Plastic Surgeon
4.7 out of 5 stars 51 reviews

This can be revised but will be more involved

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The sharp cartilages on your antihelix can be due to a number of things. When you create the antihelix with sutures in otoplasty / ear reshaping for protruding ears / prominent ears you can alter the way the sutures are placed so that they make the antihelix broader or thinner.

When they are made thinner by putting the sutures closer together, they have a tendency to make the antihelix sharper and there is a point that they can bend and create sharp angles. Also, some techniques entail cutting the cartilage which can also lead to sharp angles and obvious shapes on the antihelix which I try to avoid. The nodules could be due to the sutures creating a reaction or if the sutures were to close to the skin they can create cysts.

These cysts sometimes need to be unroofed and expressed. Your revision will entail more effort to treat. You will likely need to harvest some of the cartilage within your ear to reshape the sharp angles through cartilage grafting.

Philip Young, MD
Bellevue Facial Plastic Surgeon

Cartilage deformity after otoplasty

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Cartilage deformities after otoplasty can be due to sharp bends or tears of the cartilage. These can be improved with certain grafting techniques but best avoided in the first place.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

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.