Postauricular fascial flap and suture otoplasty: a prospective outcome study of 227 patients.
Abstract
The anterior scoring technique is criticised for a higher risk of haematoma related complications while the suture techniques for suture-extrusion and recurrence. Horlock et. al. described a suture otoplasty with addition of a postauricular fascial flap to reduce suture extrusion and noted recurrence rates of 8%. We report the senior author's experience with this technique in 227 consecutive cases. All cases were done by or under supervision of the senior author and the data collected prospectively. Complications, recurrence, revision rate and results as recorded were analysed. A total of 10 (7 early 3 late) complications were recorded (4.4%). Suture extrusion (n = 6, 2.64%), Keloids (n = 3, 1.32%), Infection, anterior skin necrosis (n = 1 each, 0.44%). A total of 6 unilateral and 5 bilateral cases had a recurrence (3.67% total ears) and 97% of recorded outcomes were reported as good or excellent results. The low complication rate seems to support the hypothesis that the fascial flap prevents suture extrusion and reduces risk of recurrence. Lack of Anterior dissection avoids risks of bleeding and haematoma.
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Other noncomparative cohorts describing a cartilage-sparing technique with a postauricular flap have reported similarly low incidences of extrusion ranging from 0% to 3%, and recurrence rates ranging from 0% to 8% of ears.
“Other noncomparative cohorts describing a cartilage-sparing technique with a postauricular flap have reported similarly low incidences of extrusion ranging from 0% to 3%, as well as recurrence rates ranging from 0% to 8% of ears. 19,22-24,28”
Supportive techniques aim to reduce both recurrence and suture-related complications by providing a well-vascularized tissue barrier over the suture line.
“To address these limitations, several supportive techniques have been introduced, with particular emphasis on the postauricular fascial flap and its variations (e.g., perichondrio-adipo-dermal flap and modified bilateral fascioperichondrial flap). These methods aim to reduce both recurrence and suture-related complications by providing a well-vascularized tissue barrier over the suture line [15,16”
From Comparative Analysis of Mustardé, Fascioperichondrial Flap, and Combined Otoplasty Techniques: Clinical Outcomes and Recurrence Rates in 365 Patients (2025) · cites this paper as [17]
Studies using a postauricular fascial flap have generally reported a low incidence of suture extrusion and recurrence, possibly due to the additional coverage and support provided by the postauricular flap.
“These studies have generally reported a low incidence of suture extrusion and recurrence, possibly due to the additional coverage and support provided by the postauricular flap. 17,23”
Several studies have modified cartilage-sparing otoplasty by including a postauricular fascial flap to cover the postauricular sutures.
“Several studies have modified cartilage-sparing otoplasty by including a postauricular fascial flap to cover the postauricular sutures. 17,19-30”
Cites
Morbidity of otoplasty: a review of 562 consecutive cases
Calder, J. C., & Naasan, A. (1994) · British Journal of Plastic Surgery · doi:10.1016/0007-1226(94)90049-3 · Cited by 136 · see citing works
The postauricular fascial flap as an adjunct to Mustardé and Furnas type otoplasty.
Horlock, N., Misra, A., & Gault, D. T. (2001) · Plastic and Reconstructive Surgery · doi:10.1097/00006534-200111000-00005 · Cited by 102 · see citing works
Comparison of cartilage scoring and cartilage sparing otoplasty: a study of 203 cases.
Mandal, A., Bahia, H., Ahmad, T., & Stewart, K. J. (2006) · Journal of Plastic, Reconstructive & Aesthetic Surgery · doi:10.1016/j.bjps.2006.01.055 · Cited by 83 · see citing works
Long-term survey of prominent ear surgery: a comparison of two methods
Tan, K. H. (1986) · British Journal of Plastic Surgery · doi:10.1016/0007-1226(86)90100-1 · Cited by 82 · see citing works
Complications following correction of prominent ears: an audit review of 122 cases
Jeffery, S. (1999) · British Journal of Plastic Surgery · doi:10.1054/bjps.1999.3183 · Cited by 67 · see citing works
Long-term results of posterior suturing with postauricular fascial flap otoplasty.
Schaverien, M. V., Al-Busaidi, S., & Stewart, K. J. (2010) · Journal of Plastic, Reconstructive & Aesthetic Surgery · doi:10.1016/j.bjps.2009.09.013 · Cited by 41 · see citing works
Otoplasty: experience with a modification using a drill, and literature review
Bajaj, Y., Rokade, A., & De, P. R. (2006) · The Journal of Laryngology & Otology · doi:10.1017/s0022215106003689 · Cited by 20 · see citing works
Reynaud, J., Gary-Bobo, A., Mateu, J., & Santoni, A. (1986) · PubMed · Cited by 7 · see citing works
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Complications after prominent ear correction: a systematic review of the literature.
Sadhra, S. S., Motahariasl, S., & Hardwicke, J. T. (2017) · Journal of Plastic, Reconstructive & Aesthetic Surgery · doi:10.1016/j.bjps.2017.05.033 · Cited by 40 · see citing works
Boroditsky, M. L., Van Slyke, A. C., & Arneja, J. S. (2020) · Plastic and Reconstructive Surgery - Global Open · doi:10.1097/gox.0000000000003103 · Cited by 30 · see citing works
Otoplasty for prominent ears—demographics and surgical timing in different populations.
Kajosaari, L., Pennanen, J., & Klockars, T. (2017) · International Journal of Pediatric Otorhinolaryngology · doi:10.1016/j.ijporl.2017.06.014 · Cited by 21 · see citing works
Prominent ear correction: a comprehensive review of fascial flaps in otoplasty.
Taş, S. (2018) · Aesthetic Surgery Journal · doi:10.1093/asj/sjx254 · Cited by 17 · see citing works
Basat, S. O., Ceran, F., Askeroglu, U., Aksan, T., Orman, C., Yazar, M., Uscetin, I., Akan, M., & Bozkurt, M. (2016) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000002832 · Cited by 15 · see citing works
Binet, A., El Ezzi, O., & De Buys Roessingh, A. (2020) · International Journal of Pediatric Otorhinolaryngology · doi:10.1016/j.ijporl.2020.110302 · Cited by 15 · see citing works
Basat, S. O., Askeroğlu, U., Aksan, T., Alleyne, B., Yazar, M., Orman, Ç., Üsçetin, İ., & Akan, M. (2014) · Aesthetic Plastic Surgery · doi:10.1007/s00266-013-0269-z · Cited by 14 · see citing works
A New Way for Antihelixplasty in Prominent Ear Surgery: Modified Postauricular Fascial Flap
Taş, S., & Benlier, E. (2016) · Annals of Plastic Surgery · doi:10.1097/sap.0000000000000309 · Cited by 10 · see citing works
Ersen, B. (2019) · Annals of Plastic Surgery · doi:10.1097/sap.0000000000002025 · Cited by 8 · see citing works
Temel, M., Şamil Kahraman, Ş., Berber, Ö., Çevik, C., & Akoğlu, E. (2016) · European Archives of Oto-Rhino-Laryngology · doi:10.1007/s00405-016-3898-4 · Cited by 6 · see citing works
Kepekçi, A. H. (2025) · Healthcare · doi:10.3390/healthcare13111325 · Cited by 5 · see citing works
Bulstrode, N. W., Ronde, E. M., & Mazeed, A. S. (2024) · Plastic & Reconstructive Surgery · doi:10.1097/prs.0000000000011342 · Cited by 4 · see citing works
Correction of prominent ears: postauricular muscle relocation and fibrofatty tissue excision.
Mehmet, G. M., & Baklaci, D. (2021) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000007480 · Cited by 4 · see citing works
Modified bilateral fasciaperichondrial flap for prominent ear correction
Aysel, A., Karatan, B., Ergün, U., & Müderris, T. (2023) · Brazilian Journal of Otorhinolaryngology · doi:10.1016/j.bjorl.2022.01.008 · Cited by 3 · see citing works
Does postauricular fascial flap reduce suture complications in otoplasty?
Albacete Neto, A., Ungarelli, L. F., Coltro, P. S., Schwartzmann, G. L., Horácio, G. S., Silva, V. Z., & Farina, J. A. (2018) · Journal of Plastic Surgery and Hand Surgery · doi:10.1080/2000656x.2018.1444618 · Cited by 3 · see citing works
Uyar, I., Aksam, E., Kopal, C., & Kapı, E. (2023) · Aesthetic Plastic Surgery · doi:10.1007/s00266-022-02838-2 · Cited by 3 · see citing works
- Authors
- Sinha, M., & Richard, B.
- Affiliations
- Birmingham Children's Hospital (GB)
- Corresponding author
- Richard, Bruce
- Venue
- Journal of Plastic, Reconstructive & Aesthetic Surgery
- Publisher
- Elsevier BV
- Published
- 2012-03
- Volume
- 65
- Issue
- 3
- Pages
- 367-371
- ISSN
- 1748-6815 (ISSN-L)
- OpenAlex
- W2072526986
- Cited by
- 36
- References
- 8
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 2 · 2022: 4 · 2021: 2 · 2020: 2 · 2019: 1 · 2018: 4 · 2017: 3 · 2016: 5 · 2015: 1 · 2014: 3 · 2013: 7
- FWCI
- 3.27
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Plastic Reconstructive & Aesthetic Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Reconstructive Facial Surgery Techniques
- Health Sciences › Medicine › Genetics › Congenital Ear and Nasal Anomalies
- Health Sciences › Medicine › Surgery › Nasal Surgery and Airway Studies
- Keywords
- suture extrusion, postoperative complications, hematoma, keloids, reoperation
- MeSH terms
- Fascia, Follow-Up Studies, Humans, Prospective Studies, Surgical Flaps, Suture Techniques, Sutures, Treatment Outcome, Patient Satisfaction, Plastic Surgery Procedures, Ear Auricle
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