Nonetheless, there are basic guidelines and “definite philosophies” that help doctors achieve permanent and natural-looking results. For instance, the cartilaginous framework of the ear must be “broken” and sutured in position so the new contour can persist long term.
Relying solely on sutures, without breaking the cartilage known for its “strong memory,” will not hold up the new shape long term.
Dr. Smiley has recently posted a series of videos on Snapchat to present a special case of otoplasty. The female patient had deformity on the right ear, while the left side had normal appearance and so it did not require surgery.
The patient’s right ear deformity was caused by two major problems: overdeveloped concha, which is the bowl of the ear, and underdeveloped helix, which is the uppermost portion of the external ear.
The excess cartilage of the concha was causing the ear to stick out more than normal, while the weak or “unsupported” helix was curled inward, resulting in an unusually short ear (vertical measurement between the helix and the earlobe).
In the Snapchat video, Dr. Smiley said the right ear was about 1 ½ cm shorter than the left side, a prominent asymmetry that affects the entire face.
The ideal vertical height of the ear, he explained, should be about the same length as the nose (between the bridge and the columella, which is the visible wall of tissue between the nostrils).
Meanwhile, the ideal protrusion of the ear’s helix or upper region is 1 ½ cm, while the earlobe should stick about 1 cm, he said. In general, otoplasty is reserved for patients whose ears stick out more than 2 cm from the side of their head.
During surgery, Dr. Smiley placed the incision behind the ear to hide the scar. This revealed the overdeveloped cartilage of the concha, which he broke and sutured to a more normal position.
With the use of correct otoplasty techniques and deep understanding of beauty ideals and proportions, ear pinning surgery can provide permanent results that can improve facial symmetry as well.