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Open Otoplasty Through Ventral Skin Incision and Abrasion of the Antihelix Under Vision

  • Original Articles
  • Craniofacial/Maxillofacial
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Common otoplasties through incisions behind the ear with blind scoring or scratching the anterior perichondrium often leave an irregular surface of the antihelix.

Method

To avoid these tiny side effects, a skin incision along the ventral antihelical fold (scapha) is used to thin and fold the flat antihelix under vision. After local anesthesia of the ventral ear skin, an incision along the scapha allows its blunt lifting toward the concha and to expose the cartilaginous antihelix. Its future shape is marked and the thickness of the cartilage is thinned with a dermabrader by approximately half or until one sees the gray of the inner cartilage. The now missing perichondrium causes the antihelix to fold by itself with an absolute smooth surface and is fixed with three absorbable mattress sutures.

Results

The technique has been developed in 1985 in Frankfurt and has since been performed on over 1000 patients with optimal results and a low complication rate. The skin flap is so well perfused that no skin necrosis and only 5.7% wound healing problems were experienced.

Conclusion

This approach from ventral is safe, timesaving, and avoids contour irregularities of the antihelix often seen after traditional techniques. It can be left to beginners in plastic surgery without hesitation. The fear of hypertrophic scars or even keloids can be dispelled with the fact that ear keloids only occur after wound infection.

Level of Evidence IV

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Acknowledgments

We thank ecomed-Verlag in Landsberg, Germany for permission to reprint the intraoperative images from our first publication in German in 1999 [22].

Author information

Authors and Affiliations

  1. Department of Plastic and Aesthetic, Reconstructive and Hand Surgery, Agaplesion Markus Krankenhaus, Wilhelm-Epsteinstr. 4, 60431, Frankfurt am Main, Germany

    Gottfried Lemperle & Shafreena Kühn

  2. Plastische Chirurgie Zug, Postplatz 1, 6300, Zug, Switzerland

    Katja Kassem-Trautmann

  3. Department of Plastic, Reconstructive and Aesthetic Surgery, Diakonie-Krankenhaus, Ringstr.64, 55543, Bad Kreuznach, Germany

    André Borsche

Authors
  1. Gottfried Lemperle
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  2. Katja Kassem-Trautmann
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  3. Shafreena Kühn
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  4. André Borsche
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Contributions

GL developed the technique and wrote the manuscript. KT-K uses this technique, drew the Fig. 6a and added Fig. 9a–d. SK collected the data of 912 patients. AB added his 443 open otoplasties and Fig. 8a, b.

Corresponding author

Correspondence to Gottfried Lemperle.

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Conflict of interest

The authors declare to have no financial interest in relation to the content of this article

Consent for Publication

The girl in Fig. 9a–d has given her written consent to the publication of her face. And the parents of the boy in Fig. 8a, b have given general written consent to publication of their son’s face for scientific publications.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Lemperle, G., Kassem-Trautmann, K., Kühn, S. et al. Open Otoplasty Through Ventral Skin Incision and Abrasion of the Antihelix Under Vision. Aesth Plast Surg 48, 378–387 (2024). https://doi.org/10.1007/s00266-023-03668-6

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  • DOI: https://doi.org/10.1007/s00266-023-03668-6

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