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.