Otoplasty, Conchal excision and future rhinoplasty. Bit of an odd question?

I am having otoplasty and a chin implant in a few weeks. I am told that conchal excision will be used to pin my ears back. I am considering rhinoplasty in the future to make the septum less visible from the side and will need cartilage grafts. Will the cartilage removed during otoplasty impact my ability to do that? Could the peice of cartilage be seperatly stitched to the mastoid fascia or something to preserve it instead of disposing of it? Should I have planned the surgeries at the same time?

Doctor Answers 12


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From what you are describing with regards to the planned nasal surgery, it should be possible to complete the surgery with your septal cartilage and not require your conchal cartilage. I perform otoplasty quite frequently and have found that conchal bowl excision results in a permanent much more natural result. The conchal cartilage could be 'stored' under the scalp but would possibly be visible cosmetically and feel strange to the touch. The ideal setup is to have the two procedures performed at the same time. Best of Luck.
George T. Moynihan MD

Chicago Facial Plastic Surgeon
4.6 out of 5 stars 28 reviews

Otoplasty and rhinoplasty

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The otoplasty procedure does not usually involve removal of cartilage from the conchal bowl. The ear cartilage is sutured back, not removed during the otoplasty procedure. For the rhinoplasty procedure the primary cartilage used when grafting is necessary, is from the nasal cartilage, not ear cartilage. For examples of otoplasty and rhinoplasty, please see the link below to our photo gallery

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Ear surgery and later nasal surgery

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Your surgeon could do your otoplasty by not removing cartilage and use only sutures to pin the ear back. Cartilage does not have to be removed in all cases. You could also store the cartilage in a pocket behind the ear. Good luck. Donald R. Nunn MD Atlanta Plastic Surgeon.

Donald Nunn, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 51 reviews

Otoplasty and rhinoplasty cartilage grafting

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Hi Mike,

We usually use septum cartilage as the go to grafting material for rhinoplasty. It is possible that ear cartilage could be needed too, but not necessarily.

I'd suggest talking with your surgeon to see if he or she thinks it's a good idea to bank the conchal ear cartilage that would otherwise be removed during your otoplasty.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 22 reviews

Otoplasty before rhinoplasty probably not an issue

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That is a very interesting and well thought out question. Most of the time, in primary rhinoplasty surgery, septal cartilage is used for grafting. It is mostly in revision cases that we look to the ears for additional cartilage, when no septal cartilage is available. The conchal shave you will have during the otoplasty is a very small amount of cartilage and not likely an amount worth 'banking.' However, more of a concern are the sutures holding back the ears. If you will need conchal cartilage harvested in the future, it is the sutures holding your ear in place that would be the issue. Talk to your surgeon about the possibility of ever needing ear cartilage. If it is a definite, you may want to have the rhinoplasty performed first. My guess is that it is unlikely that you will need the conchal cartilage for your rhinoplasty so you can proceed with your plans.

Theda C. Kontis, MD
Baltimore Facial Plastic Surgeon
5.0 out of 5 stars 42 reviews

Cartilage Excision in Otoplasty; Impact on Future Rhinoplasty

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First, I remove little or no cartilage during an otoplasty. Even if cartilage is removed it can be stored under the skin behind your ear so it can be used in the rhinoplasty procedure.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Rhinoplasty, otoplasty, conchal excision.

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Hi there. We like odd questions, they make us think!

And yours is a very good one. Cartilage grafts are routinely used in rhinoplasty. Mostly, these are from the septum which is always the first choice in a primary rhinoplasty. However, the use of conchal cartilage in revision rhinoplasty is not uncommon.

In my hands setback otoplasty often involves excision of some conchal bowl cartilage. Having found over the years that the cartilage scoring techniques are not predictable enough, a number of years ago I evolved my technique to a reversible pinna suturing technique - to achieve a straight, uncurled ear with a normal pinna to ante helix relationship - and a planned conchal bowl excision to set the corrected pinna to an appropriate (normal) angle with the side of the head.

Certainly not every case requires a conchal bowl excision, and check with your surgeon, but I think for the right patient it is an excellent procedure.

It's easy to bank the excised cartilage over the mastoid for future possible use, so your question is smart and forward thinking. Chances are it won't be needed, but why toss it out if there is even a small chance it might be useful in the future.

All the very best,

Howard Webster

Ear Cartilage from Otoplasty for Future Rhinoplasty

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You probably would not need the ear cartilage for your rhinoplasty later (as the septum would be used for grafts) but it never hurts to bank it behind the ears as a backup.

Otoplasty, Conchal excision and future rhinoplasty. Will otoplasty interfere with future rhinoplasty?

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This is a great question. First, I agree with Dr. DeMars that while cartilage is occasionally shaved from the backside of the ear, conchal excision isn't often required. Second, if you're undergoing a primary rhinoplasty in the future, the ultimate goal would be to use cartilage from within your nasal septum for grafting, as opposed to conchal cartilage. If ear cartilage was required, there is typically enough remaining after otoplasty. Given that your surgeon is proposing a less common technique, you should propose this question to them directly for the most accurate answer. I hope this information is helpful.

Stephen Weber MD, FACS

Otoplasty, Conchal excision and future rhinoplasty.

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I can't be sure in your case without photos, but in over 30 years of doing otoplasties I find it is almost never necessary to do conchal excision. Many of the worst results I have seen were because the patient had that excision. It might be good to get more than one consult before undergoing that procedure.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 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.