Otoplasty: shaping the antihelix

In completing a satisfactory repair of the prominent ear, the shape of the antihelical fold is often the key to the aesthetic outcome. Correction involves not just creating a fold in the antihelix but also establishing a smooth sweep or antihelical curve anterior to posterior as well. The essential components described include accurate scoring of the antihelical fold followed by placement of mattress fixation sutures, with emphasis on obliquely placed sutures to control the final curve and shape of the antihelix. Sutures placed obliquely can solve the problem of persistent upper-pole prominence as in a telephone deformity, or overfolding which can stigmatize otoplasty.