Author Topic: Revision Otoplasty Forum - Shell Ear, Earlobe Setback now Pain After Pinback  (Read 3812 times)

Offline DrBermant

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Dear Dr. Bermant,

About 15 years ago I had otoplasty performed to correct a fairly severe congenital "shell ear"
 condition. The surgeon who performed the operation left me with ears that had somewhat improved curvature, but were now strangely flat at the tops. In addition to this, he inexplicably set my ears closer to my head at the tops than the bottoms, giving them a rather odd appearance from this perspective as well. In the subsequent years I have lived with these results until last year, when I underwent two additional surgeries. One was an attempt to give curvature to the tops of my ears, and the other was an attempt to restore my ears to a more natural looking angle. My ears look reasonable now, however unfortunately I now have different issues. The surgeon who was charged with correcting the angle of my ears took the measure of bringing them closer to my head near my earlobes in an attempt to bring them back into a more natural alignment. He did this by folding the cartilage behind each earlobe and pushing it in toward my head. He didn't cut the cartilage but rather pushed it toward my skull, and then sutured it to the lining or sheathing around my skull. Aesthetically the result is an improved one, and the angle of my ears is closer to where it should be, however his method has left my ears essentially connected to the musculature around my head and neck so when I crane my neck to one side or the other it feels as though someone is pulling on my ears. It's been about 15 months since the surgery and the situation has become intolerable. It is especially aggravating and distracting while I'm driving. I understand from your website that you are now retired, which is unfortunate for those of us who no doubt could benefit from your expertise and attention to detail. Is there someone you could recommend who might have the skills necessary to address my issues? I am located in southern NJ, just outside of Philadelphia, but at this point I'd be willing to travel just about anywhere to be seen by the right surgeon. Thanks very much for any help or advice you may be able to provide in this matter. Have a prosperous and healthy holiday season.

Sincerely,

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

Yes, I did see many patients from around the world who preferred Travel for Otoplasty Surgery and my specific skills as a Surgical Sculptor and problem solver. Part of any such process was defining the problem. It was part of my system of Using Before and After Pictures that permitted such a process, something one or two images, are not enough.

The Scaphoid or Shell Ear Deformity comes in many different degrees and variations. Repair is an art form best documented with detailed Standard Otoplasty Pictures. Why not demonstrate the progress of what has been done to show others the progress or problems remaining.

Earlobe Setback tends to rely on a different blood supply, but I have seen so many different situations, each needed careful assessment before consider offering new surgery. Revision Otoplasty is even more demanding with potential blood supply issues putting cavalier modifications at risk of interfering with modified anatomy. This becomes more of a risk when details of surgery are long gone. Then there is the issue of the enemy of good is better that no longer is comfortable or now is a complication.

Pin Back Otoplasty, one of the elements of my Otoplasty Dynamic Technique, is not just bringing ears back, it is doing so artfully and leaving a patient comfortable. I discussed with my patients an extensive Complications of Otoplasty which can include issues like nerve injury, and what is tethered to what. However, with my skills I was able to perform my sculpture picking my tissues to anchor, protect, and modify, all in the art.

There are limitations for any surgical sculpture. I have seen too many feeling their previous deformed body part is still not "just right" seeking perfection that no real surgeon can ever give. Each new revision, if it helps, fine. But what happens when disaster sets in? Is the ear truly better. That is why the results of surgical sculpture are such an important criteria for our resources on  How to Pick Your Otoplasty Surgeon which all are free to use, explore, and suggest improvements.

This forum is designed as a meeting ground for those with problems and those who have solutions to offer. That is an avenue you are welcome to also explore. Those who post images here, are expanding the resources for others to learn from quite valuable for rare problems. Collecting them in integrated forum and resources is a powerful tool to not just learn from, but attract bright surgical minds who are looking for problems to help solve.

I still try to share my knowledge and experience here in the forum beyond the framework for those looking to seek help from others and contribute to the expanding content showing what surgery has to offer and when to consider stopping pushing something too far.

Hope this helps,

Michael Bermant, MD
Retired Plastic Surgeon
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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