- Ears should protrude no more than forty five degrees from the side of the head at the base.
- The crease inside of the ear should form two branches. This crease keeps the upper portion of the ear tilted back.
- Earring holes should be small.
COMMENT: Some people find protruding ears more bothersome than others. In some cases they are easily hidden by a hair style.
The "lop ear" or "telephone deformity" is the case in which the ear is missing the upper portion of the inner fold and the ear is then cupped.
Earring holes that are too large are easily closed.
SELF-EVALUATION:
- Check the angle of your ears from the side of your head.
- Are your ears symmetric?
- Push against the outer edge of the ear in the middle. Is your ear position satisfactory now?
- Are your earring holes stretched?
HOW MUCH CAN BE IMPROVED?
- By removing the bowl of cartilage at the base, the ear can usually be brought in about twenty to thirty degrees. Just about where you push it to.
- If the upper crease is missing, it can be recreated.
- Earring holes can be completely repaired. They should not be re-pierced in the same scar.
THE OPTIONS: THE EARS
Deformities of the ears can occur at birth, and may be corrected in infancy. The most common problem that surgeons deal with is, of course, protruding ears. Many patients like to wear their hair up or in the case of men, wear it short. For instance, people going into the military, suddenly find that their ears are sticking out after their head is shaved. Children may receive a great deal of ridicule if their ears protrude.
THE OPTION: CONCHA VERSUS HELIX
If the ear protrudes at the base, this may be the result of a simple overgrowth of the cartilage, known as the CONCHA. The general rule of thumb is that the ear should stick out no more than forty-five degrees from the head. This can be corrected by removing some of the cartilage from this area. By pressing the ear straight back in the center, you can see the anticipated result.
In this case the incision is made behind the ear and the cartilage is simply shelled out. This produces an average of twenty to twenty-five degrees of correction depending on how far the ear is pushed out and in many, many patients as a solitary operation is adequate.
There may also be some irregularity of the folding portion of the upper ear known as the HELIX. This second irregularity is usually a birth defect. In some cases, the base of the ear is well within these angles but the missing upper fold creates what is called a telephone deformity, or lop ear, in which the ear is shaped like a single shell. This deformity may be isolated to one ear.
If the loss of the upper fold is significant, it is valuable to recreate this fold. Many, many surgical procedures have been devised to fix the helix. What they basically involve is weakening the cartilage so that it can bend and then placing sutures to maintain it permanently in the desired position. The helix is fixed only if it is truly a significant component of the problem because getting the ears to match exactly may be very difficult in every case.
EAR COMPLICATIONS
- PERSISTENT PROTRUSION
They still stick out too far. More can usually be removed from the base.
- ASYMMETRY
Were they asymmetric to begin with? They will probably not match exactly afterwards anyway. It is very hard for an average observer to check both of your ears at the same time, so don't worry about small differences.
- NUMBNESS
- INFECTION OF THE CARTILAGE (CHONDRITIS)
Rare. May require high dose antibiotics.
- DISTORTION OF FOLDS
Particularly when dealing with the upper portion (helix), creating a natural curve may be difficult. Usually it's an acceptable approximation that keeps the ear turned in. Sometimes a revision is worthwhile.
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