Aesthetic Otoplasty:  Wedge Excision of a Flattened Helix to Create a Helical Curl

The prominent rim of the auricle known as the helix takes a more or less curvilinear shape, starting at the helical root anteriorly and ending approximately at the level of the intertragal notch posteriorly. Many types of malformations of the auricle exist, with the prominent ear being one of the most commonly discussed deformities in the cosmetic literature.^1-3 In many of these malformations, especially in the classic lop ear deformity, a deficient lateral overhang of the helix can exist. Creating a lateral overhang of the helix, or helical curl, that will persist has so far been an elusive endeavor in cosmetic otoplasty. Most surgeons have been satisfied with the helix’s mere prominence and relationship to the antihelix. This report calls attention to this helical flattening and presents a simple approach to obtaining a more natural appearance of the helical curl. This effect is achieved by excising a composite wedge(s) from the superior helical rim in a fashion that promotes an aesthetic tubular appearance of the helix.