Basic science approach to otoplasty for prominent ears.

Variations of the conchal setback operation for prominent ears have produced my best long-term otoplasty results. Additional use of the Mustarde mattress sutures combined with cartilage weakening techniques must be used when the anthelix cartilage is thick and flat or concaved, but they should never be used above the beginning of the inferior crus. Other additional techniques which can be used to supplement or replace the Mustarde sutures are radical postauricular skin excision and closure under tension, incision and suturing to sharpen the inferior crus, and mattress sutures from the periosteum to the fossa triangularsor anterior helix. Methods for correction of lobular protrusion are also discussed.