Techniques for improving tragus definition in auricular reconstruction with autogenous costal cartilage.

A successful total auricular reconstruction with autogenous costal cartilage depends primarily on the sculpture of the cartilaginous auricular framework. Various refinements and modifications have allowed exceptional results in experienced hands, whereas a high-defining tragus and a deep conchal cavity remain the weak links in most cases. Therefore, we advocate a modification on the fabrication of the tragus. By fastening a cartilaginous cube under the tragus, the reconstructed tragus can be projected adequately and the conchal cavity is deepened simultaneously. A total of 166 consecutive patients underwent auricular reconstruction adopting this modification between 2007 and 2009. Three cases have been selected to illustrate the favourable result of this technique. Consequently, a harmonious contour of the reconstructed auricle with detailed anatomical landmarks is achieved by precise sculpting. The reconstructed tragus is proved to be stable and rigid in the follow-up.