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Posted under Ear Surgery q&a

Otoplasty: Pros & Cons of Two Approaches

John_Landar
I am planning to undergo otoplasty to reduce the conchal bowl (i.e., to change the orientation of my ears from a prominent angle to one further back). I have consulted two surgeons, who each suggest using different approaches. One surgeon suggests an approach that involves (among other things) resecting sections of cartilage from the conchal bowl. He suggests that this procedure is likely to be free of re-drift (i.e., ears folding out again), that the ears can be set at a natural angle (e.g., 15-20 degrees), but that there may be some difference in the angle on each side. The other surgeon suggested using permanent sutures (approx. 1 cm from base of ear) to pin the ears to the fascia of the skull. He suggests that this will help prevent re-drift (that he thinks is more likely when using only cartilage resection from the conchal bowl). He also says that using permanent sutures, the ears can only be positioned flat back against the head (rather than a more natural angle). I respect the advice of both surgeons (who both appear to be competent and honest), but am confused by the conflicting opinions. What are the pros and cons of each approach? For example, how likely will complications (i.e., re-drift and/or asymmetry) using cartilage resection (i.e., without permanent sutures to the cranial fascia) occur? And could the permanent sutures be ripped (e.g., in contact sport etc.) or pulled through over time (e.g., as I age)? Thank you.

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