Background: Despite its small size the ear has a complex topographic surface. Composed of numerous convexities and concavities (hills and valleys) the ear’s underlying cartilaginous structure offers diverse features of which their exact purpose remains unclear.
Isolated from the main cartilage body, on an island so to speak, is the tragus. This is a small humped-shaped prominence of cartilage on he front edge of the concha which projects up and backward over the external auditory canal. Developing from the first hillock off of the 1st pharyngeal arch this small piece of cartilage is the most anterior structure of the ear.
While its functional purpose is stated to reflect sounds from behind into the ear, people who have lost their tragus are not known to any less hearing ability. Its name is also interesting in that its Greek origin comes the word ‘goat’ which presumably comes from the fact that in men the growth of hair resembles a goat’s beard.
From a plastic surgery perspective, the relevance of the tragus is seen in ear reconstruction and facelift surgery. As part of microtia reconstruction in children born without ears, making a semblence of the tragus to complement the creation of the main body of the ear cartilage is the final step in the ear reconstruction journey. In facelift surgery the historic debate was whether to place the anterior facelift incision in front of or behind the tragus. (we know today it is almost always better to place it behind) Also it is important in facelift surgery to not put tension on the skin closure lest the tragus become deformed and be pulled forward.
Case Study: This male was having many aspects of his ear reshaped but one of his concerns as that he no longer wanted to have a prominent tragus…or the presence of a tragus at all.
Under general anesthesia because of. numerous other procedures being done, a skin incision was made being the tragus. A skin flap was raised over the cartilage allowing the tarsal cartilage to be removed to a flat surface. The redundant skin was removed and the incision closed.
While some people may consider having a tragus as an important part of the appearance of an ear, others do not. At the least for men prone to a lot of hair growth on it, this aesthetic nuisance will forever be eliminated with its removal.
Highlights:
1) The tragus of the ear has no functional significance and can be removed for aesthetic reasons.
2) Tragus reduction consists of removing cartilage and skin.
3) For men tragus reduction has the added aesthetic benefit of removing unsightly hair growth.
Dr. Barry Eppley
Indianapolis, Indiana