Otoplasty is a relatively simple and effective procedure for reshaping the prominent ear. Cartilage bending/repositioning through sutures is the backbone of the operation with a minor role for cartilage excision/scoring. But the ability to do these maneuvers requires an incision and this is almost always placed on the back surface of the ear. While an ear that becomes more closely positioned on the side of the head would seem like it would hide any scar placed behind it, this is not always true. Poorly placed incisions can create noticeable scars to others when seen from behind.
In the June 2015 issue of the Annals of Plastic Surgery journal, the article ‘The Discrete Scar in Prominent Ear Correction: A Digital 3-Dimensional Analysis to Determine the Ideal Incision for Otoplasty’ was published. In this paper the authors studied three incision/scar locations on the back of the ear that are typically used for otoplasty surgery. Forty patients had the scar locations marked and then photographed across an 180 degree arc around the back of the ear. Using an assessment scale known as a ‘Visibility Arc’, in which the range of degrees where the scar is most visible is judged, the postauricular scar locations were compared. The objective was to determine the least visible incision—in other words, the scar with the shortest visibility arc. Scars located in the sulcus of the antihelical fold had the shortest average visible arc of about 70 degrees.The auriculocephalic sulcus had the largest visibility arc of a 100 degrees, A scar between these two locations had an 80 degree arc.
While the success of an otoplasty is primarily about how the shape and prominence of the ear turns out, the scar does play a minor role in the success of the procedure….just like most every other plastic surgery operation. Cartilage reshaping of the ear can be done through any of the three incisions so the least visible location would be the most logical choice. This study shows that the least visible scar for otoplasty lies in the posterior antihelical groove with even a slightly more medial location as almost equally good. The most visible scar is in the junction of the ear and the head. (auriculocephalic sulcus)
Dr. Barry Eppley
Indianapolis, Indiana