A Cartilage-Saving Technique for Tragus and Antitragus Fabrication in Auricular Reconstruction

<b>Background:</b> For auricular reconstruction surgery using autologous costal cartilage, younger patients typically have a limited amount of costal cartilage available. <b>Objective:</b> We introduce a cartilage-saving technique for fabricating the tragus and antitragus, and evaluate its effectiveness based on aesthetic score and complications. <b>Methods:</b> For tragus fabrication, the residual part of the seventh costal cartilage was reoriented by 90° to increase its height and carved into a seagull-shaped structure. The antitragus was constructed by bending the antihelix and stabilizing it on the broadened base frame. Postoperative aesthetic outcomes and complications were documented and analyzed. <b>Results:</b> This study included a total of 658 patients with lobule-type microtia, of whom 356 (54.1%) were male and 302 (45.9%) were female. The average age was 6.5 ± 0.7 years, and the average follow-up period was 13.6 ± 3.5 months. The average aesthetic outcome score was 9.0 ± 0.7. Wound dehiscence at the tragus was seen in four patients, while circulation disturbance at the incisura intertragica area was noted in six patients. <b>Conclusions:</b> This cartilage-sparing technique demonstrated effectiveness in shaping aesthetic tragus and antitragus.