I think when you set back your concha, sometimes you can create tension in the upper and lower parts of the ear and the possibility of a telephone deformity is greater (when the top and bottom of the ears stick out more than the middle portion.) It is effective for mild conchal prominences in my opinion.

If the movement that you are looking for is greater than 4-5 mm, a conchal setback my not be the best option. Greater movement and pinning requires excising parts of the concha. Then the decision is whether you should go through the front or the back. I’ve done many both ways. The back approach can be done without incisions that are visible in the front but you invariably have the possiblity of skin bunching up.  Shaving the cartilage and weakening it can help move the whole ear and the bowl area back against the head and this technique works quite well.

When done well, the anterior approach (incision in front of the concha) can be hidden well and you have less bunching. You definitely want someone that has discussed all of the approaches with you. This will mean that they have had a lot of experience doing these most of the time. Knowledge is key and this is especially important in the area of surgery.

The incisionless approach is attractive but offers less reliable long term results. When this is done you are totally dependent on the sutures to hold the look that you want most of the time.

When you do it open, you allow the skin to take on the new form and scar tissue helps to make the changes more permanent. It can be done for minor changes but when your ear requires significant alterations the open approach is still minimally invasive and can be done without general anesthesia and more permanent.

Many times, a prominent ear requires that the whole ear be setback. This is harder and less reliable with incision less techniques. The risk is that you pay for this non incision technique only to be left with having to do the open approach and possibly pay more in the end.  Shortcuts are just that sometimes and in the long run cost you more time and money.

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.