Aesthetic Reparation of the Face, Neck, and Auricles to Achieve Well Balance of Facial Contour

Abstract

The auricles are important organs on the facial contour that may present congenital and acquired deformities that may come associated with abnormalities of the face and neck which represent complex problems for treatment. According to my classification, all patients with congenital anomalies of the external auricles that come in combination with other imperfections of internal structures (the middle and inner ear) always present severe deformities of the face and neck. I call them anotia, agenesis of the ear, and moderate ectopic microtia, which represent 20% of all my patients that underwent ear reconstruction 13]. On the other hand, there are severe acquired deformities that damage also the face and neck, which cause unaesthetic disturbance to facial contour.

Even for a ver mindful person, the auricles may not be noticed, especially if they have normal size, shape, position and location in each side. Nevertheless, when there is any anomaly or absence, it is easy to identify the deformity which may be responsible for deep psychological repercussion.

The complex association of deformities and reconstruction of the auricle is the main problem to be solved among all imperfections of the face and neck. For acquired deformities it is useful to treat simultaneously with ear reconstruction. However, the treatment of congenital anomalies of the auricles should not be done at the same time. Combined procedures for reparation of all anatomical structures require adequate surgical planning In order to achieve a good balance between each one.

For this reason, the spatial projection of the future auricles is the key to give a good orientation for reconstruction of other deformities of the segments of the human body. If it is missing an auricular cartilage, usually it is necessary to replace it using rib cartilage graft which is performed at the first stage of the operation. When a patient presents severe facial asymmetry, it is necessary to repair the deformities using other surgical approaches in order to achieve well balance among the face, neck, and auricles.

In conclusion, each patient must be well evaluated individually in order to reach proper approach for reparation of all segments of the face and neck. In such regard rhytidoplasty operation is quite frequently performed combined to ear reconstruction as well as in other anatomical structures in the neighborhood areas.