title: Revision otoplasty:  an algorithm.
abstract: BACKGROUND
  The purpose of this study was to propose a surgical algorithm for revision otoplasty, based on an evaluation of patient concerns, desires, and clinical findings. A series of instructive cases is presented.
  
  
  METHODS
  Thirty-six patients with an average age of approximately 15 years (range, 6 to 61 years), who underwent revision otoplasty between 2006 and 2011, were included. Demographic data, complications, indications for revision surgery, and operative details were retrieved from case notes and preoperative and postoperative photographs. Aesthetic outcomes were assessed by three independent plastic surgery consultants using a survey with 15 questions.
  
  
  RESULTS
  Indications for revision otoplasty included recurrent prominence/undercorrection, distortion of scaphoid fossa, distortion of antihelical fold, hypertrophic conchal bowl, and telephone ear. The relevant surgical technique was performed according to the patient's concerns and aspirations in line with the proposed protocol of treatment and included the following: posterior suturing, conchal bowl reduction, reconstruction with conchal cartilage, or reconstruction with costal cartilage.
  
  
  CONCLUSIONS
  Otoplasty is performed frequently in young patients, and unsuccessful surgery can have a negative impact on their quality of life. Suturing techniques are safer than sculpting techniques, which can cause permanent ear deformity. Complications after sculpting techniques can lead to ear reconstruction. The proposed algorithm for revision otoplasty addresses the whole variety of ear deformations, providing the surgical options available to address these abnormalities.
authors: Edinburgh, United Kingdom From the Department of Plastic and Reconstructive Surgery, Royal Hospital for Sick Children; and the Department of Oncological Surgery and Breast Diseases, Polish Mother's Memorial Hospital-Research Institute.
authors: Pawel
authors: P
authors: Szychta
authors: Georgios
authors: G
authors: Orfaniotis
authors: Ken J
authors: KJ
authors: Stewart
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000465:Algorithms; D002648:Child; D015331:Cohort Studies; D016208:Databases, Factual; D004425:Ear Cartilage / Q000002:abnormalities* / Q000601:surgery*; D004954:Esthetics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D013536:Suture Techniques; D016896:Treatment Outcome; D006113:United Kingdom; D055815:Young Adult