Auricular displacement with rhytidectomy

The auricle is more mobile than generally recognized and is subject to displacement during rhytidectomy. When the auricle is displaced by a rhytidectomy, movement generally occurs in an anteroinferior direction with forward rotation of the inferior pole. This displacement/rotation is often obscured by concurrent elevation of the temporal hairline and insetting errors of the lobule that may appear to be the sole deformities. Using computer assistance, auricular position was compared in before and after photographs of published rhytidectomy results. Auricular displacement of varying degree was found in 62 percent of the analyzed results. Correlation of the presence, direction, and severity of the displacement with the described surgical technique implicates distraction on the periauricular superficial musculoaponeurotic system/platysma and skin at the time of closure as the causative agent. This retrospective photogrammetric study confirms that the auricle can be displaced if direct or indirect tension is placed on it during rhytidectomy.