Anterior para-helical access for open antihelical sculpting in aesthetic pinnaplasty

In cosmetic pinnaplasty, an underdeveloped or absent antihelical fold and a hypertrophic concha are the most frequent defects requiring surgical consultation. With this study, the authors intend to describe a technique consisting of an anterior para-helical incision to approach the antihelix, with no posterior approach. Advantages of this surgical approach are described. All patients consecutively operated in the period 2016–2019 by the senior author (FB) with the anterior incision technique were retrospectively included in the study. Demographic and comorbidities were sought. Postoperative patient’s reported pain and satisfaction were determined. Early and late complications were also mentioned. Forty-five Caucasian patients were included, of whom 23 were women and 22 were men. Mean age was 25 years old (range 14 to 52). Follow-up was from a minimum of 12 months to a maximum of 36 months. All complications were managed with an office-based approach. Patient’s satisfaction was rated as very good in most cases (25 patients, 56%), excellent in 9 cases (20%), good in 7 (16%) and fair in 4 (9%), and no one expressed poor satisfaction. The most common postoperative pain was mild. The parahelical anterior incision has proven to be a safe and effective technique for antihelical open sculpting. The scar tends to fade nicely and remain well hidden under the helical fold. The proposed technique allows an open approach to the antihelix and a surgical moulding under direct view, in addition to a limited risk of complications and an optimal balance compromising operative efficiency-efficacy and risks, patient’s and surgeon’s intraoperative comfort, appearance of the scar and duration of the result. Level of evidence: IV, therapeutic study