LAM FACIAL PLASTICS

Hi there

I am having difficulties pinning the lobules back to a nice-looking position after having otoplasty done 10 years ago. At that time he did not do anything to the lower half of my ear, which created a telephone look i do not like. Then a few months ago i saw a different surgeon and he performed a lobule setback where all he did was to cut out a bit of skin behind the lobule. It hasnt really improved the way i hoped. Now it seems there are different techniques and i was wondering which is best.

1. You can cut the cartilage that holds the earlobe out (called cauda helicis). You can also adjust the skin to pull back the earlobes the right amount.

2. The lobes can be sewn to the side of your face so they would be attached. This can be done under local anesthesia in the office.

3. The earlobe can be pulled back unfolding a bent cartilage with buried sutures under the skin. The inside tissue of the earlobe is sutured to the cartilage above. The sutures are located under the skin and are hidden but sometimes can be felt when pressing behind the ear.

4. V to Y soft-tissue reductions of the lobule (i have no idea what this is)

5. securing the cauda helicis to the cartilage above (which situates the lobule without risk of it migrating)

The lobes are not protruding a great deal but still enough to irritate me. Actually, it gets worse when i smile, because of the muscle movement that goes on here. Anyways the lobes are unattached. I'm not sure about suggestion number 5. which is your own. wouldnt the strain from catiladge being forced together eventually force it apart? Or am i missing the point?
Right now i am thinking that it could be an idea to cut the cartilage that holds the earlobe out (called cauda helicis) and then slightly sew the lobe to the side of the face so they would be attached. I think that it would be unwise just to sew the lobes to the side of the face as the cauda helics could pull the sutures open after a few weeks or months.

Btw. i think my antitragus (the knot just above the lobe) might be slightly bigger than average. Is this an issue? Also, i now have a scar behind the lobule. Is it a problem to do any additional surgery after that? Is it poosible to make the incision from the front to remove the cauda helics? Also i live in denmark, and perhabs these doctors arent as good as in the states. So i dont know is they can even perform option number 5.

So many questions The ear is a complicated thing.

Your time is much appreciated

1st picture : normal
2d picture : slighty from the side
3d picture : from the side

hi,
yes, i can see your problem. i have tried almost every technique you mentioned but the only one that seems to be reliable is tacking the caudal helices back. however, i have never done it in isolation without doing the whole ear. don't know how effective it would be but i assume the same. i would hate for you to come all the way here for me to work on you and it does not work perfectly to be honest. in terms of taking sutures out, i use permanent ones because i think the cauda needs to be tacked down for many months to have security. if you go back to try to remove the suture you will lose the scar tissue that was meant to hold the position of the lobe long-term.

This is very informative, thank you

Would there be any reason why tacking back the the caudal helices wouldnt work do you think?

What is normally the problem with just removing the caudal helices? No visible results?
What is normally the problem in sewing the lobe to the side of the face? Does the stiches reopen?

What would be the cost if i one day took a plane and gave you a visit?

Would there be any reason why tacking back the the caudal helices wouldnt work do you think?
DON'T KNOW BUT IT HAS NOT BEEN AS RELIABLE AS I WOULD HAVE LIKED.

What is normally the problem with just removing the caudal helices? No visible results?
THAT IS CORRECT OR AT LEAST LESS IMPRESSIVE THAN I WOULD LIKE.
What is normally the problem in sewing the lobe to the side of the face? Does the stiches reopen?
YEAH, THAT JUST WON'T WORK. YOUR LOBE WAS NOT MEANT TO BE TACKED TO YOUR FACE. THAT WOULD BE A BIT CRAZY LOOKING.
What would be the cost if i one day took a plane and gave you a visit?
YOU CAN ASK FOR A STANDARD OTOPLASTY CHARGE IF YOU EMAIL MY STAFF BECAUSE IT WILL REQUIRE ME OPENING YOUR EAR AND TACKING THINGS BACK TO HAVE THIS WORK. YOU CAN EMAIL MY STAFF AT YOUR CONVENIENCE: CONSTANZE@LAMFACIALPLASTICS.COM. PLEASE ALLOW A FEW DAYS FOR RESPONSE. MY STAFF IS MORE SWAMPED THAN I AM IN RESPONDING.