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Revision Otoplasty for Cosmetic Ear Surgery

Explore what others have to say about revision ear surgery (otoplasty).

Michael Bermant, MD
Board Certified by the American Board of Plastic Surgery

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This is the page where you can review questions and stories from patients, view the opinions of lay persons, and see answers from Dr. Bermant and other physicians. Do you want to ask a question, post an answer, or make a comment? Information E-mailed to me will be considered for posting.

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Information posted in this section does not necessarily reflect the opinion of Dr. Bermant.

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Re: Revision Otoplasty from the United Kingdom

Dear Dr Bermant

I am sorry to bother you, but I am enquiring about a problem that I have with regards to a previous otoplasty procedure I had last year.

I had very large ears originally, 1 bigger/longer than the other, and I had them pinned back to reduce their protrusion (3 years ago). But because 1 ear was bigger, it was left sticking out too far at the top. I therefore had an ear reduction (Davis procedure) to balance it out with the other ear (last year).

They look better now, but the reduced ear still looks pointed at the top, like Dr Spock. The point presses in quite easily when I apply pressure with my finger, and only 1-2mm makes all the difference. It is very frustrating to still have this problem remaining as people still stare at it (whereas before they stared at the huge size, and flicked them!). The other ear looks fine as it is round at the top.

Do you know if it is possible to depress stiff ear cartilage inwards/downwards a little, or weaken the cartilage a bit so it it looks more rounded/flatter rather than so obviously pointed? I have even considered surgical glue to hold the pointed tip down a bit, which at least might make it look better albeit falsely. But I doubt it would hold.

Thank you for reading this, and for your time, any advice would be much appreciated (I have included a picture to demonstrate the problem)

Yours Sincerely

W

United Kingdom

Dr. Bermant responds:

Thickened injured cartilage or skin can be a problem. There is nothing like the delicate relationship of normal cartilage and skin. I work very hard to maintain such refined anatomy. There are often revision otoplasty options, but such issues are best explored in person so I can feel and see the dynamics of the tissue. Some discussion can start with our preliminary remote package especially if photographs adequately demonstrate the problem.

Michael Bermant, MD
Board Certified
American Board of Plastic Surgery

Re: Revision Otoplasty for Large Ears - Travel from the UK / United Kingdom

Dear Mr Bermant,

I have researched your work on large ear reduction surgery via your website and I think you are an excellent surgeon. I would like to see if you would be able to perform surgery to reduce the size of my ears in the near future. I live in the United Kingdom and I have no problems with travelling for a consultation and then at a later date for the surgery.

I have had previous surgery on my ears about 8 years ago here in the UK and the surgeon didn't really do as I was hoping. I asked for an ear reduction and he simply pinned my ears back. I've since researched and it appears that there aren't any surgeons that I can find that specialise in ear reshaping in the UK, hence I believe that is why I only ended up with them pinned! I have no problems with attempting to retrieve the previous surgery notes for you. I have attached a image with various pics of my ears that I have found on my laptop. I could take some properly if you wish.

Please could you let me know if you would be able to help me with the matter? I would be interested in possibly flying over for a consultation in December and surgery early March if these dates would be available?
I look forward to hearing from you.

Kind regards,

D

Dr. Bermant responds:

Otoplasty pinback surgery is great for protruding ears. Reduction otoplasty is better for problems of large ears or Macrotia. Revision Otoplasty can sometimes help. We see many patients from the UK who typically start with our Preliminary Remote Discussion before coming to Virginia. Copies of your operative report, doctor(s') office notes, and before surgery images can be of great value during your evaluation.

Michael Bermant, MD
Board Certified
American Board of Plastic Surgery

Re: Revision Otoplasty Ear Surgery - Travel from Ireland

Dear Dr Bermant

My name is P. I am a 29 year old Irish male (living in Ireland) and am just over 2 months out from a bilateral otoplasty. I would first like to commend you on such a fantastic website. It has been a source of reference to me for the past 9 months in helping me to decide which surgeon to use - on the basis of your extensive, graphically detailed case studies. I've always wanted to have the surgery and did not make the decision lighty. I took over 6 months and various consultations to decide.

Having visited 3 surgeons prior to my surgery (all of whom are registered on the Irish Medical Council and fully researched) I chose a surgeon based on his specific approach to my surgery. The other 2 were simply interested (and experienced) in making the incision behind the ear and addressing the antihelical fold - whereas the surgeon I chose favored "mustarde" sutures, combined with defining/softening the antihelix. The incision was made where the ear meets the head to allow for this surgery. As my conchal wall on both ears was quite high, I dedcided this was the best option for my specific needs.

Without this becoming a long winded email about my experience and results, my question to you is this... Could I get your opinion on the results of the surgery based on before and after pictures (1 week out from surgery, 1 month and 2 months to show healing) without the surgeons notes? The reason I ask is that I'm not very impressed with the results and I'm not sure if I'm being over critical and expecting too much. I have met my surgeon at the 1 week stage and again 2 weeks ago (6 week stage) and he is of the opinion that only the tip of my right ear needs adjusting. He has agreed to do this free of charge (after 6 months healing stage) but didn't seem very confident in doing so (as if to put me off). I would like to avail of your preliminary remote package but I don't want to approach the surgeon for his surgery notes - in case I am being over critical of my results - and I do go back in Jan to have the tip of my right ear adjusted.

I feel that there is room for improvement. From a frontal view, there is very little difference to me in the protrusion of my ears and I really do feel - based on the information/images on your website - that my conchal wall could be reduced further, but more importantly the antihelical fold adressed correctly and perhaps even have a lobule setback on both ears as this was not attempted. In short, I have absolutely NO problem paying for the preliminary remote package (without the surgery notes) even if it yields no definite results or opinions. Would this be possible without the surgery notes? I have images prior to and after surgery (front, side and behind) which I took myself.

Thank you so much for taking the time to read my email and I look forward to hearing from you.

Kind Regards

P
Limerick
Ireland

Dr. Bermant responds:

We see many patients from Ireland and around the world who prefer my techniques. Two months is very early after some ear procedures. Ear tissues need to heal before most revision otoplasty operations. We are glad to give you my opinion during a preliminary remote discussion. For many patients with surgery done years ago, reports are just not available. The before surgery images can be of great value along with my Standard Otoplasty Pictures. Without the operative report, you are limiting my ability to better understand the original problem and what was done. Jane is my office manager and can help explain the process. She can normally be reached at our office by phone Monday - Friday 9-5 Eastern Time at (804) 748-7737.

Michael Bermant, MD
Board Certified
American Board of Plastic Surgery

Re: Revision Otoplasty after Surgery Done In India To Save Money - Travel from the UK / United Kingdom

hi
i am writing this mail regarding the Otoplasty. I had a congenital helix defect in my right hand side ear. Rim was missing in my right ear. I went for the plastic surgery in south India the place called Chennai (old name Madras) in reputed hospital Apollo during December 3 years ago. The plastic surgeon removed the cartilage from behind the right hand side ear to fill the defect. But after 20 days of surgery the cartilage lost the support and it was looking more worse than before. As recommended by same surgeon, to go for another surgery, this time he told me that he will put some more pressure to stand the cartilage. But this surgery also went flop the ear look the same. After second surgery i went to England for my higher studies. After completing my masters i went to back India and decided to see another doctor, as i was not happy with my ear looks. This time i was very careful in choosing the doctor so i came up the Doctor name DR.---, he is accredited doctor from the ' The American Board of Plastic Surgery.' I took the information and photograph from your website about the surgery u have done for the helix defect for 47 year old surgeon and he said he has done this type of surgery in past and he was knowing about u as he worked for 16 yrs in United States. I trusted him he removed the cartilage which was taken from the behind the right hand side ear earlier by first surgeon and he shorten the ear by pulling the helix and filling the defect. But when dressing was removed i was shocked because the shape from front and side view was awful, there is no smooth ness of skin and it as S shaped curved which make both my ear asymmetrical from the front view and side view it looks that like some accident scars, eventually it does not look like natural ear. I am sending the photograph so u can have better understanding. Choosing doctor in India was the only option for me as it cost me cheaper.

Now i am working as a full time fermentation scientist in oxford and trying to save money for the surgery in America by you. Hopefully i am willing to travel between Oct - December. By browsing your website, I have confidence in your art through your great successful experience in otoplasty surgery and u had done surgery for similar case. I am willing to spend money as i have spend all my saving for this purpose in past and i am trying to save from present job. I went for surgery three times and i guess you understand that nobody like to go again and again this painful stuff. I can not send u my past surgery documents and photographs because i lost them during my luggage theft back in India. Please advice me from having look in photographs whether this can be fix.

Many Thanks
P
Nationality: Indian

Dr. Bermant responds:

Not all doctors offer the same techniques nor skills. Results you see here on my website are typical for my surgery on my patients.

There are limitations as to what realistic surgery can offer. Scars cannot be erased, only revised with new scars. Sometimes thickened tissue can be reduced with Revision Otoplasty. We see many patients from around the world who prefer my methods and are glad to help you explore your concerns during a Preliminary Remote Discussion before coming to Virginia.

Michael Bermant, MD
Board Certified
American Board of Plastic Surgery

Re: Revision Otoplasty for Physician from Glasgow UK / United Kingdom

Dear Doctor Bermant,

I am writing you to to see if you think you could be of help to me.

I am 35 years old and in good physical health on no regular medication. 2-3 years ago[and in a time of emotional distress] i foolishly decided that i needed otoplasty for ears that i hadn't been entirely happy with for a long time. This was done by a plastic surgeon in Glasgow,UK, the procedure took approx 30 mins and has proved to be one of the biggest mistakes i have ever made. The procedure seemed to consist predominantly of scoring and removing cartilage and in retrospect the surgeon actually didnt even examine my ears even when i got into the operating theatre.

I have been left with very unnatural looking ears. To me the predominant problem seems to be due to excessive bending of the ear. This is evident on both ears. There is a very sharp looking fold on my left ear .My right ear has "rolled"/folded appearance as my ear/concha was more prominent on this side. My ears /cartilage feels unnatural and firm in places and especially around the folds i can feel where the cartilage has been scored and bent. The skin quality of my ears is also not as good as before.

In summary my main concerns are unnatural looking ears predominantly due to problems with antihelix and concha.

This has caused me great emotional distress. It is very evident to Friends, family, work mates etc[ i get daily stares and occasional comment, "can i bend your ear" etc]. I have lost all confidence, i find it difficult to meet new people and difficult to form relationships because of my embarrassment. I tend to speak to people "straight on" or with my head turned a certain way so as to not bring attention to this very obvious disfigurement. It has also impacted on my confidence and performance at work. To confound my embarrassment i am also a Doctor/GP.

I have to say that is was the very professional nature of your website that influenced me to get Otoplasty a few years ago! Is there anything you can do to help??

Yours in great Distress,

A

Dr. Bermant responds:

Unbending an Over Folded Ear can be much more difficult when the first surgery used quick fix techniques. The operative time may be short, but the uncontrolled destructive techniques are just way too unpredictable with higher risks for sharp unnatural edges and other deformities. Revision options may be limited. Such issues are best evaluated during an in office examination where I can feel the nature of the injured structures.

Michael Bermant, MD
Board Certified
American Board of Plastic Surgery

Re: Second Revision Otoplasty Travel from the UK / United Kingdom

Hi docter bermant i am a 24 year old male currently living in the uk. I had both my ears pinned back in october unfortunately the surgeon did not do a satisfactory job. In january 2 years later, i went for a revision with a different surgeon the operation went quite well the surgeon actually made a fold in my right ear as i was born with shell ear deformaty on my right ear. How ever my right ear still looks different from my left the helix rim looks different an the over all shape to could i send you some images to look at

yours sincerly d

Dr. Bermant responds:

There are limitations as to what surgery has to offer. We are glad to review your images, operative reports, and doctors' office notes during a consultation or Preliminary Remote Discussion. Jane is my office manager. She can normally be reached at our office by phone Monday - Friday 9-5 Eastern Time at (804) 748-7737.

Michael Bermant, MD
Board Certified
American Board of Plastic Surgery

Re: Revision Reduction Otoplasty Travel from the UK / United Kingdom

Dear Sir
 
I am a 31 year old male, who has large ears I recently visited a surgery in the uk and had the upper lobs reduced. However now that the ears are pinned back at the top, it is quite clear that the ears are also a different shape (strangely id never been aware just thought they protruded), one being rounded the other being under cut (as if part of the lobe is not formed). Giving my head the appearance of being heavy to one side. The plastic surgeon who carried out the procedure did tell me they would not be even however there is quite a disparity. More than I imagined.

Is there something that can be done to correct this? Will the previous surgery affect what can be done?

I have viewed your website and been astounded at what can be done.
Yours
P

Dr. Bermant responds:

Normal ears have some degree of asymmetry. Options depend on the original problem, what was done, how you healed, and other factors. We are glad to help you explore your concerns. Give our office a call to learn how we can help. Jane is my office manager. She can normally be reached at our office by phone Monday - Friday 9-5 Eastern Time at (804) 748-7737.

Michael Bermant, MD
Board Certified
American Board of Plastic Surgery

Re: Second Revision Otoplasty Travel from the UK / United Kingdom

I had an operation on my ears last April thinking that I was going to have my ears reshaped to bring the top half folded inwards a bit. What I ended up with is ears that are millimetres from my head and look really unnatural. I have been to various surgeons since then to talk about what can be done to get what I originally wanted. One surgeon suggested injecting a permanent synthetic material behind the ear to bring the ear out, but another said that can’t be done because the material will disperse over years and the effect will wear off. Another surgeon suggested having a silicon implant fitted behind the ear. I have emailed you because you seem to share my view that ears look better a bit away from the head rather than almost touching it. Your site also says “it is harder to replace what was removed and unfold what was folded”, could you please explain what you mean by replacing what was removed (what would you replace it with?). What would you suggest as the best method of getting my ears to be pushed out from my head more. If you could please take the time to answer my questions I would be very, very grateful as I am stuck with who to believe.

Dr. Bermant responds:

Ears too close to the head look unnatural and over operated. Unfolding an Over Bent Antihelix can be one of several options depending on the original problem, what was done and how you healed. Sometimes a spreader graft or implant can help. Implants have risks.

We see many patients from the UK who prefer my techniques and and glad to help you explore your options during a consultation or Preliminary Remote Discussion.

Michael Bermant, MD
Board Certified
American Board of Plastic Surgery

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