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A gentleman had an corrective ear surgery (otoplasty) done two months ago, but feels that his ears are still sticking out. He asks if his ears were undercorrected in surgery, or if it is just swelling. His surgeon said he couldn’t do anything about the position of the earlobe. He feels that the surgeon didn’t set his earlobes back properly, so he asks if they can be set back closer to his head with a second otoplasty.

New York Oculoplastic surgeon Amiya Prasad, MD reviews his photos and question in this video:

1:28 - Dr. Prasad’s background and training, and his experience in otoplasty
1:51 - How the anatomy and concepts of otoplasty are straightforward, but execution among different surgeons is more variable
2:18 - The tendency of people with prominent ears to want their ears very close to their head after surgery
2:30 - Normal ear shape fits into a range, such as a one centimeter guideline of the ear distance relative to the skull
2:50 - The ear is approached in upper, middle, and lower thirds in surgical correction, which all need to brought in closer to the head in the right amount
3:16 - How this gentleman’s earlobe pushing inward does not appear natural, but at the same time his ear looks symmetric and not excessively protuberant
3:43 - The importance of communicating with surgeon and patient about bringing the ear in an ideal way
4:18 - How surgery can bring the upper and middle of thirds in, but still have the lower third, or earlobe, still stick out
4:29 - Surgical correction of bringing in the earlobe is possible, which can be done at the time of the original otoplasty, or as a revision procedure
4:40 - Why swelling is not a factor in protrusion 2 months after surgery, but swelling should go down before revision surgery
5:06 - There are different methods of performing otoplasty, which should be discussed with the surgeon
5:15 - The importance of reviewing pictures before and after surgery to determine how much improvement in millimeters is desired, and if a revision surgery for it is worth it
5:32 - Why the human body is naturally imperfect, so having a range of satisfactory results rather than the perfect result may be more appeasing
6:00 - The ear can be set back further with surgery as long as there is room, but the look of the result is subjective, and should be determined by the patient and his doctor

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