What are the different types of sutures used for Otoplasty? And can an ear be set back again if there is redrift? (photo)

Dear JamesThanks for posting your question.Personally, I use a suture technique using a permanent braided stitch - precisely to avoid the risk of stretch of the stitch over time, which might result in protrusion of the ears.I feel that the techniques that use stitches allow me more control over the shaping of the ear, as opposed to other techniques that score or excise the cartilage I would suggest consulting with a plastic surgeon experienced in otoplasty operations (correction of prominent ears) for further discussions and adviceGood luck

It really depends on the amount of correction required and the technique utilized.  I have used both monofilament and braided suture.  From your view point, it's best to find a surgeon who is familiar with the various techniques available and can explain to you why his/her recommendation makes sense.  It's important to understand that with every procedure there is a chance of a revision.  The interplay between the suture material, cartilage, healing process and aging is not necessarily predictable.Thanks for asking!Dr Ellen Mahony

There are many different types of suture that can be used. In my experience a monofilament suture tends to work nicely and has a slightly lower risk of infection or stitch abscess. The most critical part of the procedure is where and how the sutures are placed. Re-protrusion is very low risk after a properly performed otoplasty. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

The trend today is towards permanent monofilament sutures. The loss of correction does not depend on the type of suture material used, but rather on the method of operating. The minimally invasive stitch method, where prolene threads are used and the cartilage is no longer worked on, shows the lowest relapse rates.

often, the goal of otoplasty is to reshape the bend of the antihelix using sutures. Often monofilament sutures are used because they slide through tissue easier, and perhaps are less prone to infection. Braided sutures seem to hold their knots better but can be more abrasive (cut through tissue), and maybe more prone to infection (because bacteria can get trapped into the braids of the suture).The older the individual, the stronger and stiffer the ear cartilage. This means the suture must overcome greater cartilage strength in older patients, which can result in a higher incidence of "loss of correction." Sometimes to counteract this, surgeons can weaken the cartilage by making small incisions or abrading it with a rasp. Also, I usually try to over correct by about 15%.Revisions can be done without much problem as long as the previous surgeries did not cause excessive scarring or excessively damage the underlying ear cartilage.

The otoplasty procedure involves making cuts in the cartilage and sewing the cartilage together with permanent sutures. We use braided sutures rather clear monofilament which tend to hold tissues better. There still can be re-drift which would take a touch of procedure sometime within the first year.

Sutures alone often will result in recurrence of ear protrusion, especially in adult patients who tend to have stiffer cartilage.  Revision is certainly possible and tends to be more successful if the cartilage is made a little less stiff to help maintain the original correction.

The type of suture used in an otoplasty is usually based on surgeon preference as well as choice of technique. many surgeons will use permanent sutures (nylon is common) to keep the re-positioned ear in the correct place for an extended period of time while scar tissue forms. revisions can be done if necessary.

It is unusual to need a revision of an otoplasty if it is performed properly.  If there is a recurrence it can be revised in the future.  

Thanks for your question. I only use permanent, monofilament sutures, but i also rasp ( weaken) the cartilage, for avoiding loss of correction. Every PS have a technique that, on his/her hands, deliver the best result, i think you dont need to worry about technique selection, leave that to your PS, what you should worry is selecting the proper PS who will deliver the result you want.Every surgery can be revised, i don think of a case (if needed) that cannot be revised.Best of Luck,Dr. Luis Redondo