Does postauricular fascial flap reduce suture complications in otoplasty?
Open accessAbstract
Numerous suture techniques and covering flaps have been described to minimize complications related to sutures in otoplasty. The split postauricular fascial flap is one of such techniques, and it has been used to pad otoplasty suture. The aim of this study was to evaluate complications related to nonabsorbable cartilage sutures in otoplasty, using a variation of the split postauricular fascial flap. In this retrospective case series, we analyzed otoplasty patients in whom simplified split postauricular fascial flap was utilized. A postauricular skin ellipse was de-epithelialized (preserving dermis) and a longitudinally split in half. Flaps were dissected, and they were positioned on the cartilage to promote additional soft tissue coverage to the sutures. The lateral flap covered conchoscaphal sutures while the medial flap covered the conchomastoid sutures. Both the flaps were not sutured to cartilage. Early and late postoperative complications were evaluated. A total of 142 patients were included. Twenty-four (16.9%) patients developed late complications: 13 (9.1%) patients had palpable and visible sutures, nine (6.3%) had suture extrusion and two (1.4%) had hypertrophic scars. In this case series, the simplified split postauricular flap did not prevent or reduce late complications related to suture extrusion in otoplasty. It is possible that suturing the entire length of the flaps may play a role in our results. So, anchoring the flap and possibly tightening it a little may be an important technical step to prevent extrusion of sutures whenever the postauricular flap is used.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Prominent ear is the most frequent congenital external ear deformity, affecting roughly 5% of the general population.
“Prominent ear is the most frequent congenital external ear deformity, affecting roughly 5% of the general population.1–3”
From Outcomes and Complications of the Mustardé Otoplasty: A “Good–Fast–Cheap” Technique for the Prominent Ear Deformity (2020) · cites this paper as [1]
Many studies and prior meta-analyses confirmed otoplasty's safety.
“Many studies and prior meta-analyses confirmed otoplasty’s safety, though incisionless techniques had higher blistering (22.6%) and suture extrusion (21.9%).104–108”
From Otoplasty Surgical Techniques and Clinical Outcomes: A Practical Review (2026) · cites this paper as [107]
Incisionless techniques had higher suture extrusion, at 21.9%.
“Many studies and prior meta-analyses confirmed otoplasty’s safety, though incisionless techniques had higher blistering (22.6%) and suture extrusion (21.9%).104–108”
From Otoplasty Surgical Techniques and Clinical Outcomes: A Practical Review (2026) · cites this paper as [107]
Incisionless techniques had higher blistering, at 22.6%.
“Many studies and prior meta-analyses confirmed otoplasty’s safety, though incisionless techniques had higher blistering (22.6%) and suture extrusion (21.9%).104–108”
From Otoplasty Surgical Techniques and Clinical Outcomes: A Practical Review (2026) · cites this paper as [107]
Cites
The correction of prominent ears using simple mattress sutures
Mustardé, J. C. (1963) · British Journal of Plastic Surgery · doi:10.1016/s0007-1226(63)80100-9 · Cited by 426 · see citing works
Correction of prominent ears by concha-mastoid sutures
FURNAS, D. W. (1968) · Plastic and Reconstructive Surgery · doi:10.1097/00006534-196809000-00001 · Cited by 329 · cited 1× · see citing works
“Even established techniques such as Mustard e and Furnas have several reports of complications related to sutures [1,5,6].”
MethodComplications of otoplasty: a literature review.
Limandjaja, G. C., Breugem, C. C., Mink van der Molen, A. B., & Kon, M. (2009) · Journal of Plastic, Reconstructive & Aesthetic Surgery · doi:10.1016/j.bjps.2008.06.043 · Cited by 151 · cited 1× · see citing works
“Even established techniques such as Mustard e and Furnas have several reports of complications related to sutures [1,5,6].”
MethodThe 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
Otoplasty: Anterior Scoring Technique and Results in 500 Cases
Caouette‐Laberge, L., Guay, N. A., Bortoluzzi, P. A., & Belleville, C. (2000) · Plastic & Reconstructive Surgery · doi:10.1097/00006534-200002000-00004 · Cited by 100 · 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
Complications in the treatment of prominent ears
Elliott, R. A. (1978) · Clinics in Plastic Surgery · doi:10.1016/s0094-1298(20)32154-4 · Cited by 73 · see citing works
Handler, E. B., Song, T., & Shih, C. (2013) · Facial Plastic Surgery Clinics of North America · doi:10.1016/j.fsc.2013.08.001 · Cited by 58 · see citing works
Otoplasty for the Protruded Ear
Nazarian, R., & Eshraghi, A. (2011) · Seminars in Plastic Surgery · doi:10.1055/s-0031-1288921 · Cited by 47 · see citing works
Furnas, D. W. (2002) · Clinics in Plastic Surgery · doi:10.1016/s0094-1298(01)00014-1 · Cited by 44 · see citing works
Cartilage-sparing otoplasty: a review with long-term results
Vuyk, H. D. (1997) · The Journal of Laryngology & Otology · doi:10.1017/s0022215100137545 · Cited by 40 · see citing works
Postauricular fascial flap and suture otoplasty: a prospective outcome study of 227 patients.
Sinha, M., & Richard, B. (2012) · Journal of Plastic, Reconstructive & Aesthetic Surgery · doi:10.1016/j.bjps.2011.09.018 · Cited by 36 · see citing works
Goode, R. L., Proffitt, S. D., & Rafaty, F. M. (1970) · Archives of Otolaryngology - Head and Neck Surgery · doi:10.1001/archotol.1970.00770040510009 · Cited by 31 · see citing works
Suture materials in otoplasty.
Rigg, B. M. (1979) · Plastic and Reconstructive Surgery · doi:10.1097/00006534-197903000-00022 · Cited by 28 · cited 2× · see citing works
“All techniques describe a general concept of using postauricular flaps in otoplasty, however, flaps have notable differences among the studies [7,9,23,24].”
BackgroundOtoplasty: a review of the surgical techniques
Richards, S. D., Jebreel, A., & Capper, R. (2005) · Clinical Otolaryngology · doi:10.1111/j.1365-2273.2004.00939.x · Cited by 25 · see citing works
Retrospective Analysis of the Farrior Technique for Otoplasty
Scharer, S. A., Farrior, E. H., & Farrior, R. T. (2007) · Archives of Facial Plastic Surgery · doi:10.1001/archfaci.9.3.167 · Cited by 22 · see citing works
Otoplasty: A Comparison of Techniques for Antihelical Defects Treatment
Panettiere, P., Marchetti, L., Accorsi, D., & Gaudio, G.-A. D. (2003) · Aesthetic Plastic Surgery · doi:10.1007/s00266-003-3073-3 · Cited by 21 · see citing works
Cartilage-Sparing Complete Otoplasty Technique: A 10-Year Experience in 100 Patients
Burstein, F. D. (2003) · Journal of Craniofacial Surgery · doi:10.1097/00001665-200307000-00024 · Cited by 19 · see citing works
Sensibility of the Ear After Otoplasty
Coltro, P. S., Alves, H. R. N., Gallafrio, S. T., Busnardo, F. D. F., & Ferreira, M. C. (2011) · Annals of Plastic Surgery · doi:10.1097/sap.0b013e31820bcc11 · Cited by 18 · see citing works
Irkoren, S., Kucukkaya, D., Sivrioglu, N., & Ozkan, H. S. (2014) · European Archives of Oto-Rhino-Laryngology · doi:10.1007/s00405-013-2552-7 · Cited by 17 · see citing works
Surgical Correction of Prominent Ear Using Modified Tube Technique and Posterior Approach
Cho, B. C., Chung, H. Y., & Park, J. W. (2003) · Journal of Craniofacial Surgery · doi:10.1097/00001665-200309000-00031 · Cited by 14 · see citing works
Ungarelli, L. F., de Andrade, C. Z. N., Marques, E. G. S. C., Jorge, J. L. G., Neto, B. F. M., de Andrade, G. A. M., Lima, R. V. K. S., Nunes, A. A., & Farina, J. A. (2016) · Aesthetic Plastic Surgery · doi:10.1007/s00266-016-0678-x · Cited by 8 · see citing works
Eficácia do retalho adipofascial retroauricular em otoplastia
Ungarelli, L. F. (2012) · Revista Brasileira de Cirurgia Plástica · doi:10.1590/s1983-51752012000200014 · Cited by 2 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
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
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
Otoplasty Surgical Techniques and Clinical Outcomes: A Practical Review
Kaleeny, J. D., & Janis, J. E. (2026) · Plastic and Reconstructive Surgery - Global Open · doi:10.1097/gox.0000000000007404
- Authors
- Albacete Neto, A., Ungarelli, L. F., Coltro, P. S., Schwartzmann, G. L., Horácio, G. S., Silva, V. Z., & Farina, J. A.
- Affiliations
- Division of Plastic Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- Universidade de São Paulo (BR)
- Corresponding author
- Coltro, Pedro Soler
- Venue
- Journal of Plastic Surgery and Hand Surgery
- Published
- 2018-03-05
- Volume
- 52
- Issue
- 4
- Pages
- 225-228
- ISSN
- 2000-656X (ISSN-L)
- 2000-6764
- OpenAlex
- W2793589158
- Cited by
- 3
- References
- 24
- Citations by year
- 2026: 1 · 2021: 1 · 2020: 1
- FWCI
- 0.52
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- Journal of Plastic Surgery and Hand Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Reconstructive Facial Surgery Techniques
- Health Sciences › Medicine › Surgery › Nasal Surgery and Airway Studies
- Health Sciences › Medicine › Genetics › Congenital Ear and Nasal Anomalies
- Keywords
- otoplasty, suture complications, suture extrusion, hypertrophic scars, postoperative complications
- MeSH terms
- Adolescent, Adult, Child, Female, Humans, Male, Postoperative Complications, Retrospective Studies, Otologic Surgical Procedures, Surgical Flaps, Suture Techniques, Plastic Surgery Procedures, Ear Auricle, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
