Inflatable Surgical Tissue Expansion
Definition: A tissue expander is an inflatable implant that’s designed to stretch muscle and skin to create room for a future, more permanent implant. Think of it like a balloon where increasing amounts of liquid or gas are added over time till the skin is stretched enough to accommodate the implant.
Goal: Achieving a natural appearing ear reconstruction is one of the most challenging of body mods because of its complex three-dimensional structure. So, my goal is to develop a standardized, minimally invasive otoplasty for creating a naturalistic Stahl's Ear popularly known as a Pointed, Fairy, Elven, Vulcan Ears.
The External Ear Structure (Pinna or Auricle)
To create a natural pointed Helix we need a fluid progression upward from the Upper Tubercle to Helix and across the upper ear including the Sacaphoid Fossa, Crural of AnteHelix, Crus of Helix, Triangular Fossa.
In most ear pointing the technique of pointing typically sacrifices tissue for the sake of creating a point. To create a more natural point means we need additional skin to extend the shape of the Helix along a more natural arc.
We begin with an external scan of the ear structure, and use the hand, palpation in combination with a measurement gauge to better guesstimate each ear’s cartilaginous structural dimensions.
Conceptually borrowing from origami, or more accurately, active origami structures we design our form in software to expand along a specific path to expand the upper ear in the desired larger pointed shape.
Surgery: I think I have a workable method of endoscopic self-surgery to implant each of these, and assuming the tissue expansion works well over 6 to 8 weeks, no leaks, or get horribly infected, I would repeat the procedure and replace the inflatable elements with a permanent shaped silicone scaffold that extends the natural contour of the ear’s cartilage.
Another thought was to extract a piece of my own rib cartilage,(it will grow back), sculpt it to the necessary shape, and implant that instead of the silicone models object.
Reference: Active Origami: Modeling, Design, and Applications
https://www.amazon.com/Active-Origami-Modeling-Design-Applications-ebook-dp-B07FL4BFW8/dp/B07FL4BFW8/
Reference: Surgeons Performing Self-Surgery: A Review from Around the World
Translational Research in Anatomy | Volume 10, March 2018, Pages 1-3
https://www.sciencedirect.com/science/article/pii/S2214854X17300237
Note: I speculate that ultrasound measurement of subcutaneous tissue could be employed for a more accurate personalized modelling of the ear’s internal cartilaginous structure.