Aesthetic Otoplasty With Remodeling of the Antihelix for the Correction of the Prominent Ear:  Criteria and Personal Technique

Transfixion marks made with a hypodermic needle, the tip of which is filled with methylene blue. A temporary tattoo is thus applied on the anterior and posterior aspects of the ear and the cartilage.

A cartilaginous incision is made at the posterior aspect of the cartilage, thus permitting its approach to the anterior aspect of the cartilage.

The dissected cartilage in its anterior aspect is shown; it is attached to the subcutaneous tissue and the perichondrium in its posterior aspect.

Multiple and multidirectional hemitransfixion incisions are made on the anterior aspect of the cartilage to enhance its rolling and the neoformation of the antihelix. Notice the resection of the posterior skin of the ear and the provisional tattoo in the cartilage made with the transfixion maneuver of the hypodermic needle. The tattoo marks the reference points that will ensure achievement of the preoperative plan.

Preoperative (A, C, E, G, and I) and postoperative (B, D, F, H, and J) views of a 6-year-old boy whose antihelixes were remodeled. This case illustrates the immediate results obtained by remodeling the antihelix, with practically no edema. Note the great asymmetry of both ears in the preoperative views.The postoperative posterior view (F) shows the preservation of the auriculomastoid groove. There is very mild postoperative edema (H and J), but the natural formation of the antihelix is apparent without any transfixion sutures.