Otoplasty incisions can be done all through the back of your ear. From this posterior approach you can bend the ear back to create the curl or mound that is in the inside and superior portion of the ear called the superior crus of the antihelix.  Also from the posterior approach you can set back the ear for people with prominent conchas by taking out tissue in the back of the ear and suturing the concha to the tissue behind the ear. This is specifically called a conchal setback.

The only time you need an incision in the front of the ear is when you really need to set back the concha more than 5mm. Then an anterior approach that would require also taking some cartilage from the conchal bowl would be considered. This can also be done from the back of the ear but you usually have to deal with extra skin that is not easily laid down given the extra skin you will have when you take out cartilage.

My experience has shown that the anterior approach can be done in a subtle way and the incision can be hidden in the shadow of the conchal bowl and more times than not look better than the posterior approach for resecting some of the concha bowl.

The shape of the ears is supposed to enhance your hearing. You may notice some very minimal improvement but the research on this is minimal.  There are times when you setback the ear that can cause the cartilage to impinge the ear canal and this can actually worsen your hearing to a degree.  Otoplasty that can help your hearing is when it is done in conjunction with more complicated surgeries for a condition called microtia.  This is when the ear is rudimentary in form.

What can come with this is canal atresia when the ear canal is very small and unable to conduct air but most of the time maintains the ability to hear through the bones of your skull, meaning the nerves and some of the bones that conduct hearing to your nerves are still functional.  Otoplasty for microtia is part of a bigger plan to open up the canal and allow for air conduction of hearing.

It all depends on how long ago you had the procedure. Your wound slowly accumulates its previous strength but it will never be as strong as it was. The max strength that you get compared to native untouched skin or tissue is 89%. This is based on studies that test wound strength through tension experiments that test at what point a wound was likely to come a part.

After your procedure, you will gain 60% at 6 weeks, 80% at 6 months, and 88-89% at 2 years.  So, it takes a while to regain most of the strength back. This is important to know when you start exercising after your procedure.

Contact sports is okay especially if you wear head gear. There is no exact answer to which contact sport is or is no okay. The more trauma the worst the damage that you can create to your ears. Otoplasty is dependent most of the time from sutures earlier on and then later scarring that holds the ear in place. Trauma early on based on the above information and previous studies is worse than if it happens later.

Typically, otoplasty costs averages around 2-4k per ear depending on the above.  Anesthesia costs can also make it higher. You definitely want to go to someone with a lot of experience with different types of corrections.

There are many elements to the appearance of the ear. You can have the upper or lower parts of the ear more prominent and this requires different approaches.  Sometimes the bowl region of the ear next to the ear canal is more protruding and there are different ways to handle this too.  Sutures are generally used to pin the ear back and incisions are made in the back of the ear and heal almost imperceptibly.

This is a question that I answered for someone who had a procedure by another physician.

If one ear is pinned back to far you can revise it to make it so it matches with the other side. In terms of the approach to reverse this it would depend on how the pinning was done. If the pinning was largely due to curling of the antihelix then you may need to release the curl and the scarring that is maintaining that will need to be released.

Additional sutures may be needed to recreate or set the curl to the desired amount. If the excessive pinning is due to the conchal setback then you may need to release the setback suture and possibly add some tissue to give it some support in the more lateral position.

If the setback is due to cartilage excision, you may need some cartilage grafts to reconstruct the concha in the more lateral position that is more desirable. Some of the tissue that could be needed is cartilage that can be used to lift the ear at its base to help lateralize the ear. This is a technique that is used in microtia or ears that are severly malformed.

This was addressed to a question for a person who had otoplasty by another surgeon who had one ear more pinned down as opposed to the other treated ear.

The side of the ear with a more pinned down appearance can be treated if needed.  One thing to realize is that the top of your ear is likely to lateralize or shift away from your head with time. But having symmetric ears to begin with after your procedure is an important first step. You may want to ask your surgeon if you haven’t already about his plan to help you through this asymmetry.  Sometimes swelling on one side more than the other is the cause and it will go down and even out after time.  Your Surgeon will know best about what is going on.

Sometimes, it can be due to how you sleep and temporary curling of your ear cartilage right after your procedure can be the culprit and this can last for a while. Your surgeon will know the best. If you do need correction of this, a revision can do this with some effort. It will depend on where the asymmetry is located. If is because your ear is setback to far, you may need some tissue opposed between your ear and your skull.

If it’s due to the top portion of the ear being too curled this can be released and resutured to treat the asymmetry. Healing takes time. Numbness can be present for 6 months to a year after a procedure. The nerves grow a millimeter a day in the best  of conditions and will take time to reach the numb areas. You typically gain 60% of your wound strength at 6 weeks and 80% at 6 months. This is a good way to gauge how your healing is taking place.

If things go as planned, you should pretty much have a normal looking ear 1-2 weeks after your procedure. It takes skill to make sure that this happens on the part of your surgeon. Meticulous control of oozing makes a difference as well as frequent followups. Sometimes, surgeons will make little drainage holes in the field of the otoplasty procedure to allow for drainage that usually heals imperceptibly. Others employ small drains to help with the healing.

The less trauma your surgeon does during the procedure helps with healing as well.  The more skillful you do the surgery, the better. I usually wrap the person the first 24 hours to 72 hours and then the patient wears a head band after procedure nonstop for 1 week and then at night for 2 months. The sutures I place are usually absorbable, but I still have them come back the day after and then 6-7 days after the procedure and then 1-2 weeks after that.