Abstract
Prominent ear deformities often result from a combination of hypertrophic conchal
cartilage and an underdeveloped antihelical fold. Traditional otoplasty techniques,
such as antihelical folding sutures and conchal setback maneuvers, may introduce tension
and risk of relapse, leading to suboptimal aesthetic outcomes. The Pillars Concept represents an alternative surgical approach specifically designed to address hypertrophic
concha, ensuring stable and natural results.
This study aimed to present the Pillars Concept as an alternative method for correcting
hypertrophic conchal cartilage, highlighting its advantages over traditional techniques,
and evaluating its effectiveness in maintaining long-term stability of the ear's position
without relapse.
A retrospective analysis was conducted on 89 patients who underwent otoplasty utilizing
the Pillars Concept. The technique involves selective transection of two supporting
pillars located in the superior and inferior conchal regions after partial resection
of the hypertrophic concha. This releases the conchal cartilage and enables tension-free
repositioning of the auricular framework.
Of the 89 cases, no hypertrophic concha recurrences were noted during follow-up periods.
Complications were minimal, with only two patients (2.2%) experiencing a sensation
of “glued ears” following complete conchal resection. Retroauricular fullness was
observed in two cases (2.2%) after conchal setback, primarily due to inadequate management
of the residual cartilage length. Patient satisfaction was high, and the natural aesthetic
of the auricle was consistently preserved.
The Pillars Concept provides a reliable, tension-free method for addressing hypertrophic
conchal cartilage in otoplasty, preserving the natural ear anatomy and ensuring long-term
stability without the risk of relapse. This technique should be considered a valuable
addition to the armamentarium of otoplasty procedures.
Keywords
otoplasty - hypertrophic concha - Pillars Concept - tension-free otoplasty - preservation
otoplasty
