Techniques for improving tragus definition in auricular reconstruction with autogenous costal cartilage

SummaryA successful total auricular reconstruction with autogenous costal cartilage depends primarily on the sculpture of the cartilaginous auricular framework. Various refinements and modifications have allowed exceptional results in experienced hands, whereas a high-defining tragus and a deep conchal cavity remain the weak links in most cases. Therefore, we advocate a modification on the fabrication of the tragus. By fastening a cartilaginous cube under the tragus, the reconstructed tragus can be projected adequately and the conchal cavity is deepened simultaneously. A total of 166 consecutive patients underwent auricular reconstruction adopting this modification between 2007 and 2009. Three cases have been selected to illustrate the favourable result of this technique. Consequently, a harmonious contour of the reconstructed auricle with detailed anatomical landmarks is achieved by precise sculpting. The reconstructed tragus is proved to be stable and rigid in the follow-up.