Two-flap earlobe rotation for extensive mid-helix defect: a case report of a new modification to an existing technique

Reconstructing ear defects in very elderly patients is challenging, but one-step procedures are beneficial due to reduced morbidity and fewer hospital visits while maintaining ear size, shape, and symmetry. In 2018, Jaber <i>et al</i>. introduced a 90° earlobe rotation technique to repair full-thickness auricular defects while preserving the earlobe. We present a modified approach, dividing the earlobe into two flaps for better mobility, rotating them to cover a mid-helix defect in a 93-year-old patient. This is especially useful for older patients with large earlobes, who are prone to skin cancers like keratinocyte cancer. The cosmetic result is satisfactory, with minor asymmetries rarely an issue. This technique provides a practical, single-step solution for functional and esthetic reconstruction in elderly patients.