Otoplasty is the most common ear reshaping surgery which primarily treats the prominent or protruding ear. Treatment of the ear that sticks out has been done since Ancient India and a wide variety of techniques have been done for it. But regardless of the otoplasty technique it has been historically taught that the helix, and not the antihelix, should be seen from the front view. If the helix is pulled behind the antihelix then the otoplasty result is deemed to be overcorrected.
In the March 2015 issue of the Annals of Plastic Surgery in the Published Ahead Of Print section, a paper appeared entitled ‘The Prominent Antihelix and Helix-The Myth of the ‘Overcorrected’ Ear in Otoplasty?’ In this paper the authors set out to define the role of the antihelix in normal ears and how it is perceived from an aesthetic standpoint. Pictures of ears were used and judged to choose their favorite and their least favorite ears based on their aesthetic appeal. The two most popular ear shapes were compared. Interestingly the aesthetically preferred ear had a prominent anihelix…contradicting what is taught in otoplasty surgery. The authors also found that a prominent antihelix was common in the general population and is really normal and not abnormal. Also interesting was that the helix of the ear chosen as the most aesthetic was the one where it almost touched the side of the head.
While it is still never a good idea to have the helix pulled back too far in otoplasty surgery, a prominent antihelix is not necessarily a negative ear attribute. Ultimately it is up to the patient to judge their own ear aesthetics and whether it is overcorrected should this concern arise. An interesting aside of this study was that the authors noted that most people do not know their own shape as they were unable to recognize their own ears in pictures.
Dr. Barry Eppley
Indianapolis, Indiana