Reduction otoplasty for correction of the large or asymmetrical ear

Abstract

The pinna anatomically should sit within the boundaries of the middle 1/3 of the face. It has an extremely variable and intricate internal anatomy. There are four main anatomical subunits of the pinna. These are the helix, the conchal bowl, the antihelix, and the lobe. It is the anatomical relationships of these that create the overall appearance of the pinna. The proportions of the pinna are described. The key to a successful outcome for ear reduction surgery is appropriate preoperative assessment to determine where the excess is and strategic placement of incisions to hide the resultant scars at the junctions of the aesthetic subunits of the ear. The placement of scars at the junctions of aesthetic subunits in the face leads to the least notable scars. Similarly, incisions on the anterior surface of the pinna at the junction of its anatomic subunits (the helical rim, the antihelix with the superior and inferior crura, the conchal bowl, and the lobe) will reliably produce scars that become virtually imperceptible. The surgical technique is discussed.