Definition and Causes
The two main causes for this are a lack of the usual cartilage fold in the upper one third and/or an excess of cartilage in the bowl. Otoplasty is a procedure to reshape the deformed cartilage and excise any areas of excessive cartilage. This is done through a well hidden incision behind the ear. Otoplasty is best performed at younger ages when the cartilage is still very soft and malleable. As we age, all cartilage in our body (ribs, discs of the spine, etc.) becomes stiffer and more brittle; this makes re-shaping more difficult and less reliable. However, otoplasty can be performed with good results up to age 50 to 60.
How To Treat
There are various techniques for otoplasty depending on the specific causes of the prominence. To re-create the anti-helix (or the missing line of cartilage in prominent ears), permanent sutures are used to fold the cartilage back towards the head. This is typically combined with a controlled weakening of the cartilage in this area to prevent relapse of the prominence. Scoring (fine cuts) or roughing (otobrasion) is performed on the outer surface of the cartilage to weaken it. This makes the sutures more effective in countering the “memory” of the cartilage – or to reduce the tendency of the cartilage to spring back out to its previous position.
In some patients, there is an actual excess of cartilage – typically found in the bowl (concha). Cartilage is excised in these cases to help with the set back of the ear. All of these techniques can be performed together to obtain the optimal correction. These maneuvers are performed under the skin, so there is little visible evidence, except for a natural appearing, set-back ear.
Surgery lasts approximately 2 to 3 hours and is usually scheduled as an outpatient. Recovery involves wearing a cotton head-dressing for one week. This dressing is contoured specifically to reduce swelling and maintain the shape of the ear in the early healing period. Dr. Ha does not utilize drains but recommends a gentle compressive head band to be worn for 4 weeks for protection and swelling reduction.