Otoplasty is a common cosmetic procedure can reposition prominent ears closer to the head, creating a balanced facial appearance. In my view, the best technique to achieve natural and reliable outcomes relies on cartilage scoring—a precise method to reshape the ear’s underlying structure.
The Power of Cartilage “Scoring” in Otoplasty
The ear’s shape is determined by cartilage, which can be firm and resistant. When a prominent ear lacks a defined antihelical fold, cartlage scoring is able to create this natural fold. This method, also called a cartilage-sparing technique, doesn’t remove large portions of cartilage. Instead, the technique carefully scores or scratches the front (anterior) surface of the cartilage via an incision from behind the ear where the scar is best hidden.
Why scoring? Cartilage has a natural “spring” or memory. According to the Gibson Principle, when the front surface is weakened by scoring, the cartilage naturally bends away from the injured side. This allows the creation of a smooth, natural-looking antihelical fold, effectively “pinning” the ear back without the stiffness or unnatural appearance sometimes associated with older, cartilage-cutting methods.
The scoring technique is combined with fine, long-lasting but ultimately dissolving sutures to create the new, desirable shape. The goal is always a symmetrical and permanent correction.
There are some ear shapes that require a different or combination approach. Some ears do not fully form in a condition known as microtia and in this setting there may be other types of procedures recommended.
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