Is it possible to create an antihelical fold without the use of permanent sutures in otoplasty?

Question

I'd like to know the process of creating an antihelical fold in otoplasty. What does the actual procedure involve and can it be done without the use of permanent sutures? I recently had my permanent sutures removed from just using the stitch method (no cartilage removal) as it was causing too many infections. My GP told me it was because it was a foreign body. As soon as I had them removed I have experienced no issues except now my ears stick out again.

Jonathan Adamthwaite, FRCS (Plast) · Answer

Many thanks for your question. It is possible to create an antihelical fold without permanent sutures by using EarFold a small gold plated implant composed of memory metal that can be inserted with small incisions at the front of the ear under local anaesthetic (awake). This sits in front of the cartilage and holds it in place. Alternatively, after a period of settling a more traditional permanent suture technique can be performed once more. The decision as to which procedure would achieve the best result for you would require an in person assessment with a surgeon fully qualified and experienced in both techniques.
All the best,
Jonathan

Leo Kim, FRACS(Plast), MS(Plast), MBBS(Hons) · Answer

There is a couple of ways to weaken the cartilage, making the chances of the ear sticking back out and it involves use of an instrument called "otobrader" which is a small metal rod with a barb. You can also do an open technique and make small cuts on the side to bend the cartilage and weaken it, the technique is called "scoring". Permanent sutures though lessen the risk of recurrence.
Wishing you the best in your journey,
Dr Leo Kim
Specialist Plastic Surgeon in Sydney

J. Stewart Humphrey, MD · Answer

The antihelical fold is typically created by abrading the anterior surface of the cartilage and then folding the cartilage by placing sutures on the posterior surface of the cartilage. Acute or chronic low grade infections can occur (and are more likely if the suture is braided versus monofilament) leading to extrusion and or the need for removal to clear the infection. I would recommend that you allow 6 months to a year to pass then consider reoperation. Permanent sutures will be required in order to form and hold the fold. Hope this helps.

Waldemar Merck, MD · Answer

It is normal for the ear to return to its former position if the permanent sutures had to be removed within the first 8 to 10 years after the operation. However, I recommend that you have permanent sutures inserted again the next time. For this I presume that your operating surgeon has enough experience with the Dr Merck Stitch Method. Otherwise mistakes can sneak in quite easily and lead to the sutures, although they are tolerated, coming to the surface of the skin of the ear  again and having to be removed once more.

Rachel A. Ruotolo, MD, FACS · Answer

Otoplasty is a surgical technique used to correct prominent and/or asymmetric ears.  Multiple techniques are used depending upon the goals of surgery. There isn't just one technique that addresses each issue. Permanent sutures are essential in order to be able to create a lasting result.  There are several different types of sutures that can be used, however. Perhaps you had a reaction to that particular suture. Seek consultation with a board certified plastic surgeon who is experienced with external ear surgery. Ask him/her about which sutures they use and make sure you know which sutures were used in your previous surgery. Good Luck!

Is it possible to create an antihelical fold without the use of permanent sutures in otoplasty?

Answers (5)

Answer: Is it possible to create an antihelical fold without the use of permanent sutures in otoplasty?

Answer: Is it possible to create an antihelical fold without the use of permanent sutures in otoplasty?

Answer: Otoplasty techniques

Answer: Otoplasty techniques

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Is it possible to create an antihelical fold without the use of permanent sutures in otoplasty?

Answers (5)

Answer: Is it possible to create an antihelical fold without the use of permanent sutures in otoplasty?

Answer: Is it possible to create an antihelical fold without the use of permanent sutures in otoplasty?

Answer: Otoplasty techniques

Answer: Otoplasty techniques

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Recommended reading

Everything you need to know about Ear Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.