Author Topic: Otoplasty Forum - Ears Distorted After Earlobe Reduction & Facelift Necklift  (Read 5799 times)

Offline DrBermant

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Dear Dr. Bermant-
 
 
I have been researching plastic surgery ear repair and came across your website.
 
 
I had a facelift with a temple lift, neck lift and fat transfer in - by a very reputable Board certified plastic surgeon in Newport Beach.
At this time, upon his suggestion, I had my earlobes reduced.
 
His work was excellent for the most part. My face looks very natural and I am mostly happy. I say mostly because one earlobe is attached and one is detached. The detached earlobe hangs lower.  The attached earlobe has ruffles in it.
The doctor told me to wait until now to see if the ruffles smoothed out. They did not. The attached lobe comes to a point and has a little red mark. The doctor said that that ear is perfect. He plans to detach the other ear, but I do not think he plans to (or knows how to) fix the ruffles. I am a bit uneasy about this revision surgery to the attached earlobe next week because I am not sure the doctor is very experienced at this type of revision; in fact, he tried to convince me that my ears looked better now than before.  I am thinking that I need to go to someone that has more of an expertise at this and wondering if you can help me find someone, since it seemed that you did this type of work a lot in your practice.
 
Also, I have excess skin left behind my ears, but he seemed really familiar how to fix this.
 
I live in Orange County California and would really appreciate your help. I will gladly send you pictures.
 
Thank you in advance.

This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.

Sorry, I am retired and no longer offer evaluations or reviewing pictures in private. I do try to share my experiences here on this forum as you can see. You are welcome to post images here using my Standard Pictures for Ear Deformity but issues may extend beyond those views alone when facelift is concerned. This Standard Facelift Pictures Discussion Thread summarizes where I stand about documentation of the face for deformities, emotions, and structural issues shown on motion.

The problem with earlobe deformity after combined Facelift Surgery, Neck Lift  and Earlobe Reduction Surgery is that there can be one or more elements as factors involved.

The key to Facelift and Neck Lift surgery is designing the structural support to exclude the ears, then reattach the ears in the surrounding tissues new location without tension. Just how the ears look on this reattachment is part of the art of this surgery.

Each of my Facelift Consultations went into a good deal of detail about this issue. The distorted ear from stress and how it is attached can include many possible complication after facelift neck alone. "Ruffles" can be a sign of tension transmitted to the ears, but they can be distortions from other factors. There are so many different types of facelift and neck lifts that can play different roles in such a deformity.

That one ear is not attached and the other one not, can also be a complication of the earlobe sculpture of the facelift or as part of the Earlobe Reduction which also comes with many different types of surgical designs.

When I was evaluating such problems from patients of other surgeons, I would ask to see the before surgery pictures, operative report, and many other issues before trying to understand what might need to be done. Standard Pictures are a start. If deeper structural forces are factors, photographic documentation may not enough, and the hands on exam in conjunction with a review of the operative report might be needed to feel what is going on before understanding what happened. When there was a deeper structural component to the problem, sometimes I could not offer a repair without addressing the underlying factors.

Having extra skin behind the ears after otoplasty is a common occurrence when the ears are brought back closer to the head. I told such patients to expect it. We used to remove that excess earlier in my career and learned that leaving it to adjust itself had major benefits for our otoplasty patients, in how the ear looked from behind. But excess skin behind the ears after a facelift? Why? What was done? are questions I would want to understand. 

This forum was designed for those with issues after surgery to share their experiences, concerns, and discuss issues. You are welcome to join us.

We have resources here on How to Pick Otoplasty Surgeon and How to Chose Your Plastic Surgeon. I have yet to build the Facelift surgeon resources. Board certification is critical, but what board? That is one of the components of that resource.

There is much to learn before selecting who is to do the revision surgery, the original surgeon or some specialist. The original surgeon has the best understanding of what was done. But then again that the problem resulted after surgery by that doctor. Better understanding if one is looking for a Facelift Neck Lift specialist or an Otoplasty Specialist might be of interest.

Hope this helps,

Michael Bermant, MD
Learn More About Otoplasty Ear Surgery
Michael Bermant, MD
Retired Plastic Surgeon
Surgical Sculptor, Artist, Creative Thinker, Problem Solver
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Offline DrBermant

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Thank you for the response.  It makes me greatly question if I am going to have revision surgery done next week by the same surgeon. Thanks

This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.

You are welcome. Revision Otoplasty can be a complex topic especially when many things could contribute to a deformity. Analysis of each element is part of the equation I used when trying to solve problems. It is something like being a Sherlock Holmes detective: elementary or looking at each component. That means more than the components of surgery, but also the documentation: before photos, standard pictures now, what happened during surgery, what happened after and so forth. The fun was having clinical exams come so close to what I had detected before even seeing a patient. That was something I was able to achieve to an extraordinary degree with the male chest. The ear and face are harder to achieve the details without the hands on part. Scarring ear cartilage does not translate to pictures or movies. But the human face does as for many aspects of expressions and facial muscle movement. I am considering revising my facelift sections to show the early documentation I did before my practice further specialized.

Sometimes it is best to have the same surgeon do the revision. Knowledge of what was there can be a powerful advantage. Sometimes such issues are best thought about carefully when the issue is elective, not an emergency.

Why not share your concerns here to firm up your thoughts or help others better understand before they have surgery themselves. It is not just a surgeon who can make advances in the field of documentation. Evolving the standard pictures / movies as discussed in Face Lift Standard Pictures Forum Discussion can be a powerful tool to understand problems and solutions.

Hope this helps,

Michael Bermant, MD
Learn More About Otoplasty Ear Surgery
Michael Bermant, MD
Retired Plastic Surgeon
Surgical Sculptor, Artist, Creative Thinker, Problem Solver
Plastic Surgery
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