Correcting the lobule in otoplasty using the fillet technique.

IMPORTANCE Correction of the protruded lobule in otoplasty continues to represent an important challenge. The lack of skeletal elements within the lobule makes a controlled lobule repositioning less predictable. OBJECTIVE To present a new surgical technique for lobule correction in otoplasty. DESIGN, SETTING, AND PARTICIPANTS Human cadaver studies were performed for detailed anatomical analysis of lobule deformities. In addition, we evaluated a novel algorithmic approach to correction of the lobule in 12 consecutive patients. INTERVENTIONS/EXPOSURES: Otoplasty with surgical correction of lobule using the fillet technique. MAIN OUTCOMES AND MEASURES The surgical outcome in the 12 most recent consecutive patients with at least 3 months of follow-up was assessed retrospectively. The postsurgical results were independently reviewed by a panel of noninvolved experts. RESULTS The 3 major anatomic components of lobular deformities are the axial angular protrusion, the coronal angular protrusion, and the inherent shape. The fillet technique described in the present report addressed all 3 aspects in an effective way. Clinical data analysis revealed no immediate or long-term complications associated with this new surgical method. The patients' subjective rating and the panel's objective rating revealed "good" to "very good" postoperative results. CONCLUSIONS AND RELEVANCE This newly described fillet technique represents a safe and efficient method to correct protruded ear lobules in otoplasty. It allows precise and predictable positioning of the lobule with an excellent safety profile. LEVEL OF EVIDENCE 4.