Have you ever wondered why so many boxers, rugby athletes, soccer players, and mixed martial arts fighters have misshapen ears? It’s because they have absorbed so many repeated blows that the framework of the ear has collapsed from the ongoing damage.
Cauliflower Ear is the non-technical term used to describe the formation of excess scar tissue and irregular healing following a single or repeated trauma to the ear shell. Small pools of blood called hematomas begin to form in the ear tissue, depriving ear cartilage of normal blood supply so that the cartilage eventually dies. The scar tissue that replaces or accompanies the formation of new cartilage appears malformed, lumpy, and warped, looking very much like the surface of a cauliflower plant.
Not an Easy Fix
The repair of a cauliflower ear is usually more demanding and complex than standard Otoplasty surgery. This is because there is a risk that an inexperienced surgeon may cause more damage, on top of the damage that’s already been done by the patient. Choosing the right otoplasty surgeon — one with a proven track record repairing cauliflower ear — is essential to ensure the best possible results.
When ear trauma involving hematoma is treated shortly after an injury, the doctor will drain the pooled blood to prevent blood flow to the cartilage from becoming blocked and causing further damage. Pressure is then applied to the ear to help retain its normal shape and minimize swelling.
Many people, however, do not seek treatment immediately and wait for the end result, which is cauliflower ear. This is when specialized surgery is necessary to correct the ear deformity. More often than not, cauliflower ear can be stopped before it develops following trauma.
It’s a delicate surgical procedure — one that requires making an incision in the ear to access and remove the underlying malformed scar tissue. Once this is done, the surgeon will replace the skin flap and suture it closed. Care must be taken not to create more scar tissue as a result of surgical trauma. In mild cases of cauliflower ear, the surgeon often will employ tools in the form of a splint or bolster so that the correct pressure is applied to the incision area to prevent a recurrence of the deformity.
In severe cases, the surgeon may need to replace and rebuild the entire cartilage structure using a cartilage graft or synthetic material such as porous polyethylene construct.
Prevention Is Worth the Effort
The key to preventing cauliflower ear is to seek medical attention as soon as possible following severe trauma. In the absence of injury, use common sense and always wear proper protective gear to prevent ear trauma in the first place. Athletes such as boxers and wrestlers therefore should always wear head gear to protect their ears from constant blows and normal rough and tumble contact. Little League baseball or softball players should always wear a batter’s helmet that covers the ear facing the pitcher. Because a single blow to the ear from a poorly pitched ball could mean living for years with a cauliflower ear.
People who work in construction or other physical jobs should also be mindful of ear protection.
And, when choosing an otoplasty surgeon, make sure he or she is board certified at minimum. This will ensure that the surgeon has the training required to do cosmetic surgery. Make sure the surgeon has more experience than just doing otoplasty, but also has the right credentials and the right kind of experience fixing cauliflower ear, given the delicacy of the operation.
The average recovery time is around four weeks. Avoid any kind of physical activity — contact sports in particular — after surgery so that you don’t risk a new injury and undoing a costly repair to your ears, as well as your appearance and self-esteem.
Otoplasty is performed by renowned facial plastic surgeon Dr. Edwin Williams III at the Williams Center Plastic Surgery Specialists. The Williams Center has locations in Albany and Manhattan. To schedule a consultation with the board certified surgeon, please call 800-742-2797.
About the Author: Dr. Edwin Williams
Dr. Edwin Williams is a double board-certified facial plastic surgeon who founded The Williams Center in 1993. He has performed over 10,000 facial plastic surgery procedures and has pioneered the deep plane facelift. He served on the Board of Directors for the American Academy of Facial Plastic Surgery for over a decade, and served as President from 2015-2016. In 2016, 2017, 2018 and 2019, Dr. Williams earned the Castle Connelly Top Doctors award in New York Facial Plastic Surgery.
Dr. Edwin F. Williams III attended Cornell University in Ithaca, New York where he received a Bachelor of Science degree in 1982. He began medical school at the State University of Buffalo School of Medicine and received his Doctor of Medicine in 1986.
Dr. Williams is actively involved in teaching facial plastic and reconstruction surgery to the residents of the Albany Medical Center and is former Chief of the Section of Facial and Plastic Reconstruction Surgery at Albany Medical Center where he received an academic appointment of Clinical Professor, Department of Surgery.