Author Topic: pointed & protruding ear abnormalities?  (Read 3579 times)

Offline Drew

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pointed & protruding ear abnormalities?
« on: October 30, 2012, 11:10:33 PM »
I've been searching for several months for a surgeon that has dealt with a case that involves a severe protrusion and "pointed" ear tips. Are there any recent before and afters that anyone has seen and could post? I've found a lot of surgeons who appear to have performed simple "pin backs" mostly successfully. But I haven't been able to find any before and after pics of a true reshaping of a pointed "elf" ear appearance.

I've been wanting to get this surgery done for as long as I can remember. I'd decided last winter I was finally going to do it, but I'm having extreme difficulty finding the best surgeon for the job.


Thanks for any help in advance.

Offline DrBermant

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Re: pointed & protruding ear abnormalities?
« Reply #1 on: October 31, 2012, 01:00:59 AM »
I've been searching for several months for a surgeon that has dealt with a case that involves a severe protrusion and "pointed" ear tips. Are there any recent before and afters that anyone has seen and could post? I've found a lot of surgeons who appear to have performed simple "pin backs" mostly successfully. But I haven't been able to find any before and after pics of a true reshaping of a pointed "elf" ear appearance.

I've been wanting to get this surgery done for as long as I can remember. I'd decided last winter I was finally going to do it, but I'm having extreme difficulty finding the best surgeon for the job.


Thanks for any help in advance.

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

In a previous post answer I wrote:

New to the forum, just researching Stahl's Ear Deformity. I have what appears to be an extreme case, very, very pointed and a great deal of protrusion. They're definitely the main focus point of my profile and quite distracting to most people while talking to me for the first time. I'm not certain they will ever look "normal" even with surgery. I'm curious to know if any surgeon would have an opportunity to look at them. I'd like to get a realistic opinion on whether they're something that can even be dealt with, how extensive the surgery would be and an idea on cost. I would feel more comfortable having them looked at via video feed rather than posting pictures on here. Is that a possibility?

 Thanks for any help or advice in advance.  ;D

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

Welcome to our forum!

The Stahl Ear Deformity comes in many different degrees. The success of the surgery depends on the specific problem, skill of the surgeon and many other factors.

This forum does permit individuals to post their images. Sorry, our forum does not have private video feeds for viewing (I know of no forum that does). Privacy is better found during a consultation. When I was in practice we did offer Remote Consultations. However that was with complete pictures for documentation, not video feeds. Face obscuring images interfere with adequate evaluations for surgery recommendations.

Forum discussions are less demanding, but the views given are not as accurate as those during an actual consult. You can post Standard Otoplasty Pictures blocking out the face. The identity can usually be obscured by editing the region from outer edge of eyebrow to outer edge of eyebrow and down to just below the lips. Leaving the chin establishes a facial proportion. You can see such examples on my site such as this Revision Otoplasty. Another option is to just hide the eyes as I have done here on this Scaphoid Macrotia Ear Reduction Otoplasty.

The Stahl Deformity pictures are best also served with an additional views showing the ear shape with the extra fold flipped out as demonstrated on the Stahl link above.

When learning How to Choose Your Otoplasty Surgeon look for before and after surgery pictures of this problem and ask your surgeon about the chances of achieving such results. These deformities are rare and not all patients permit the use of their images for public education.

It can become a challenge when dealing with rare plastic surgery problem or complication finding exact examples. When you come down to it, each plastic surgery problem is actually unique. It is rare to find even body true symmetry, the left matching the right. This is not just a situation for the patient looking for a best doctor, it is for the surgeon offering the surgical sculpture. Can one doctor do everything? Not as well as someone who finds a their area of passion and concentrates. Such concentration can start as a specialty as Plastic Surgery, but then there are those who concentrate on breasts, ears, or gynecomastia.

I guess if I had to reflect, my specialty was problem solving, technology and evolving a better way to do things. That is how my skills developed. I took problems, documented them, fixed them, and documented what I had done for others to see my problem solving skills and methods. However, I am a computer geek and can take a problem, dissect its components, solve it, do it, and put it up for all to see on the Internet. Not all surgeons can do that. Most need to hire a programmer for each thing they put on the Internet. But then the public is faced with gambling to travel sometime great distances to a specialist to then see a photo book in the office? Not practical, but that is what still happens today.

If a specific problem and solution is not there, then the next option is to look how that surgeon demonstrates each skill down from the most to least complex related activity.

Factors involved:
Ear Anatomy Specific Issues
Reconstructive Flap Surgery
Cartilage Ear Surgery
Travel for Otoplasty Surgery when seeking specialst far from home
Reconstructive Plastic Surgery but now we are getting very general.

Such options would include examples of Revision Otoplasty Surgery, then Revision Flap Based Surgery (moving tissue around,) Then Revision Facial Surgery. But then one is losing the Anatomy of the ear a critical factor in otoplasty choices. The next cascade would be to see how someone manages a parallel but similar tack making a new ear like Microtia small ear deformity or repair after trauma or cancer defects. Then there is the caulitflower ear, for which I have yet to see something that can reproduce the true elegance of thin skin cartilage look after this deformity becomes permanent.

Here are a variety of flap based ear sculptures requiring skills that could be used to evaluate potential Revision Otoplasty skills.

Macrotia Big Ear Reduction,

Antia Bush Helix Rim Reconstructive Otoplasty Ear Surgery,

Scapha and Helix Ear Reduction Otoplasty  Ear Surgery

Gauge Earlobe Repair

Congenital Cleft Earlobe Repair

Earlobe Repair but this is so much more simple than the cartilage reconstruction needed for the top of the ear.

Perhaps I will be able to add to my resources here with more examples of my sculpture to show what I achieved. It will be like an artist collecting their lifetime unpublished work and putting them for others to learn from and understand the possible. Kind of like going to a museum. I have always admired Leonardo da Vinci and love when I can view and enjoy his works. I know I can't go out to get him to paint or draw me something, but I can look for elements I like in that artist and find someone who has similar skills and style. That is how you take the rare and unusal and expand the search to find the closest next option. The risk becomes just how far does the relaxation of exact lapse. Obviously when going to someone with no examples of anything otoplasty or just pin backs, the risks of being outside that surgeons comfort zone becomes a risk unless either that surgeon is just gifted or can demonstrate similar parallel cases. That is how I  did it when patients asked.

Some problems have no good options. Some new operations are evolved. Doctors are learning and increasing skills. Patience sometimes is better than making something worse. There were problems I told some patients I could not improve nor fix. One way to stimulate such growth or change is to put the problem visually up on the web to see and stimulate others to solve. That can be better than just hoping someone puts an exact example up on their web site for you or someone else to search and use. That is why this forum has ability to post photos. However they should be my Standard Otoplasty Pictures set so that contours can be analyzed and better understood. That is why I designed that tool for my patients to send me information before traveling for my surgery or further exam in my office so I could feel the tissue to see its nature before offering revision surgery. Having copies of prior operation, office records, before surgery pictures were elements I also asked for when trying to solve problems. Do not post something private, but there are options to show show the ear without the whole face blocking off features. Video links can add your emotional concerns to stimulate surgeons to thinking of offering solutions. There the editing of the face becomes so much more difficult. Posting Pictures in Forum

So there are proactive options available for those who want to try more than waiting for others to deliver.

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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