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Suture materials in otoplasty.
Abstract
From my experiences in 101 otoplasties of the Mustardé type, the buried suture materials have shown individual variations, as regards granuloma and slippage complications. As a result, I now prefer 4/0 clear nylon for reconstruction of the anti-helix, 3/0 white Mersilene for concha-mastoidal fixation, and 4/0 chromic or subcuticular Vicryl for skin closure.
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The Mustardé technique, using conchoscaphal mattress sutures to recreate the antihelical fold, remains widely used but risks suture pull-through in firm cartilage.
“Mustardé14 technique, using conchoscaphal mattress sutures to recreate the antihelical fold, remains widely used but risks suture pull-through in firm cartilage.16,17”
From Otoplasty Surgical Techniques and Clinical Outcomes: A Practical Review (2026) · cites this paper as [17]
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Otoplasty: Critical review of clinical results
Adamson, P. A., Mcgraw, B. L., & Tropper, G. J. (1991) · The Laryngoscope · doi:10.1288/00005537-199108000-00013 · Cited by 99
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
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
“The retro-auricular scar tissue probably forms the basis for eventual strength of repair while maintaining the shape and the position of the cartilaginous ear (Rigg, 1979; Tardy and Dennis, 1981; Adamson et al., 1990).”
BackgroundThe Anterior-Posterior Otoplasty
Burres, S. A. (1998) · Archives of Otolaryngology - Head and Neck Surgery · doi:10.1001/archotol.124.2.181 · Cited by 25
Cihandide, E., Kayiran, O., Aydin, E. E., & Uzunismail, A. (2016) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000002607 · Cited by 25
Stewart, K. J., & Lancerotto, L. (2017) · Facial Plastic Surgery Clinics of North America · doi:10.1016/j.fsc.2017.09.002 · Cited by 25
Effect of Different Suture Materials on Cartilage Reshaping
Iamphongsai, S., Eshraghi, Y., Totonchi, A. S., et al. (2009) · Aesthetic Surgery Journal · doi:10.1016/j.asj.2009.01.016 · Cited by 22
Effects of Different Suture Materials on Cartilage Reshaping
Cagici, C. A., Cakmak, O., Bal, N., Yavuz, H., & Tuncer, I. (2008) · Archives of Facial Plastic Surgery · doi:10.1001/archfaci.10.2.124 · Cited by 17
Otoplasty: A Graduated Approach
Foda, H. M. T. (1999) · Aesthetic Plastic Surgery · doi:10.1007/s002669900310 · Cited by 13
“In cases where these maneuvers were felt not to be enough to overcome the spring action of the cartilage, breaking of the cartilage spring by a full-thickness incision was performed to avoid postoperative superior pole lateralization, which is reported in many studies to be the most common cause of revision in otoplas…”
BackgroundResultAlzayadneh, I., Glikson, E., Shapiro, J., Rival, E., Solomon, Z., & Solomon, P. (2022) · Aesthetic Surgery Journal · doi:10.1093/asj/sjac079 · Cited by 7
The Effectiveness of Posturicular Fascial Flap as an Adjunct to Suture Otoplasty
Abdilkarim, D. A., Qader, A. R., & Mohammed, S. A. (2016) · Kurdistan Journal of Applied Research · doi:10.24017/science.2016.1.1.4 · Cited by 7
Otoplasty and Ear Reconstruction Complications
Buba, C. M., & Gantous, A. M. (2024) · Facial Plastic Surgery · doi:10.1055/a-2446-0354 · Cited by 4
“It is essential to explain to the patient that commitment to the instructions will positively impact the results and substantially decrease the risk of complications.”
Cartilage Curvature Reshaping: A Quantitative Assessment
Aśadi, K., Hashemian, S. J., Salehi, S. H., & Mousavi, S. J. (2021) · Aesthetic Surgery Journal · doi:10.1093/asj/sjab328 · Cited by 4
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
“All techniques describe a general concept of using postauricular flaps in otoplasty, however, flaps have notable differences among the studies [7,9,23,24].”
BackgroundEficácia do retalho adipofascial retroauricular em otoplastia
Ungarelli, L. F. (2012) · Revista Brasileira de Cirurgia Plástica · doi:10.1590/s1983-51752012000200014 · Cited by 2
Aesthetic Alteration of Prominent Ears
Posnick, J. C. (2013) · Elsevier eBooks · doi:10.1016/b978-1-4557-2698-1.00039-3 · Cited by 2
Raposo, A., Calero, J., Martínez, A. J. G., Giribet, A., Barrios, A., & Garcia-Purriños, F. J. (2019) · Journal of Plastic Reconstructive & Aesthetic Surgery · doi:10.1016/j.bjps.2019.05.028 · Cited by 1
Cortes, W., & Gosain, A. K. (2009) · Elsevier eBooks · doi:10.1016/b978-1-4160-4081-1.50057-6 · Cited by 1
Cheney, M. L., & Rounds, M. F. (1997) · Facial Plastic Surgery Clinics of North America · doi:10.1016/s1064-7406(23)00283-3 · Cited by 1
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
Die Konturstabilität nach Otapostasiskorrektur durch anteriore Ritztechnik
Yildirim, Y., Fischer, H., & Gubisch, W. (2007) · HNO · doi:10.1007/s00106-006-1508-2
Diamond Burr Drill Use in Otoplasty
Bajaj, Y., & Choudhury, N. (2013) · Springer eBooks · doi:10.1007/978-3-642-35431-1_30
Schreiber, N. T. N., & Mobley, S. R. (2013) · Springer eBooks · doi:10.1007/978-3-642-35431-1_10
External knot for running intradermal stitch
Leach, G. A., Chaffin, H. M., Bristyan, M. C., et al. (2020) · Journal of Cutaneous and Aesthetic Surgery · doi:10.4103/jcas.jcas_83_19
“Having the knot external mitigates the risk associated with granuloma and abscess formation posed by buried knots with the standard technique.[4-7] Moreover, this technique maximizes cosmetic outcomes as the external knot minimizes the bulky, “dog-ear” appearance at the proximal apex commonly associated with the more…”
Method(2008) · Archives of Facial Plastic Surgery · doi:10.1001/archfaci.10.2.129
Cartilage Curvature Reshaping: Polydioxanone Plate Versus Suture
Aśadi, K., & Hashemian, S. J. (2026) · Aesthetic Plastic Surgery · doi:10.1007/s00266-026-05624-6
Metadata
- Authors
- Rigg, B. M.
- Corresponding author
- Rigg, Bruce M.
- Venue
- Plastic and Reconstructive Surgery
- Published
- 1979-03
- Volume
- 63
- Issue
- 3
- Pages
- 409-410
- ISSN
- 0032-1052 (ISSN-L)
- OpenAlex
- W2031935736
- Cited by
- 28
- References
- 0
- Citations by year
- 2026: 2 · 2024: 1 · 2022: 1 · 2021: 1 · 2020: 1 · 2019: 1 · 2018: 2 · 2017: 1 · 2016: 3 · 2013: 3 · 2012: 1
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Plastic & Reconstructive Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Reconstructive Facial Surgery Techniques
- Health Sciences › Medicine › Surgery › Surgical Sutures and Adhesives
- Health Sciences › Medicine › Surgery › Nasal Surgery and Airway Studies
- Keywords
- otoplasty, suture materials, granuloma, suture slippage, Mersilene, Vicryl, skin closure
- MeSH terms
- Ear Diseases, Ear, External, Granuloma, Humans, Polyethylene Terephthalates, Sutures
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