Prominent ears are not one deformity. They are usually a combination problem involving the antihelix, concha, and lobule. In this episode, we break down a practical, anatomy-first approach to otoplasty that helps you create a natural setback without a sharp, overdone, or obviously operated appearance.

We review the major causes of auricular prominence, the aesthetic goals of correction, and the core maneuvers every plastic surgery resident should know. The focus is on reliable, cartilage-sparing principles: Mustarde sutures for antihelical recreation, Furnas sutures and selective conchal reduction for conchal excess, and deliberate management of the lobule so you do not leave behind a hockey-stick deformity. We also cover timing, infant ear molding, postoperative care, and complications worth respecting.

Key Takeaways

• Prominent ears usually reflect a combination of underdeveloped antihelical fold, conchal excess, and lobule prominence.
• The goal is a soft, natural, harmonious setback with visible helical rim from the front and a straight helical contour from behind.
• Mustarde mattress sutures remain a foundational technique for recreating the antihelix.
• Furnas concha-mastoid sutures help address middle-third prominence by reducing the concha-mastoid angle.
• Lobule correction matters; ignoring it can leave a disharmonious result despite an otherwise good otoplasty.
• Early neonatal ear molding can permanently improve selected deformities without surgery.

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References

1. Thorne CH, Wilkes G. Ear deformities, otoplasty, and ear reconstruction. Plast Reconstr Surg. 2012;129(4):701e-716e. doi:10.1097/PRS.0b013e3182450d9f. PMID: 22456385.
2. Mustardé JC. Correction of prominent ears using buried mattress sutures. Clin Plast Surg. 1978;5(3):459-464. PMID: 359224.
3. Furnas DW. Correction of prominent ears by conchamastoid sutures. Plast Reconstr Surg. 1968;42(3):189-193. doi:10.1097/00006534-196809000-00001. PMID: 4878456.
4. Gosain AK, Recinos RF. A novel approach to correction of the prominent lobule during otoplasty. Plast Reconstr Surg. 2003;112(2):575-583. doi:10.1097/01.PRS.0000071000.80092.2A. PMID: 12900617.

Disclaimer: This content is for educational purposes only and is not medical advice.

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