title: Island technique for prominent ears: an update of the Ivo Pitanguy clinic experience.
abstract: BACKGROUND
  Prominent ears are a relatively common and instantly-recognizable condition. Numerous studies have reported psychological distress, emotional trauma, and behavioral problems associated with this deformity in childhood. The multitude of approaches clearly indicates the lack of a definitive technique to correct this issue in all patients.
  
  
  OBJECTIVE
  The authors describe the "island technique," originated by the senior author (IP), which involves dissecting a cartilaginous island to reconstruct the antihelix and the triangular fossa and correct the conchascaphal angle.
  
  
  METHODS
  The authors retrospectively reviewed the charts of all patients (n = 111) who underwent otoplasty with the island technique at the senior author's private clinic between July 1990 and July 2008. Patients who underwent treatment with a modified island technique or any other approach were excluded. Charts were examined for patient history and demographics, etiology, concurrent procedures, and complications.
  
  
  RESULTS
  Eighty patients were female (72%); 31 were male (28%). The average age was 28.2 years (range, five to 65). The most common etiology was a combination of overdeveloped concha and an underdeveloped antihelical fold (n = 76, 69%). Other facial aesthetic procedures were simultaneously performed in 54 patients (49%). Early complications occurred in two patients (1.8%), including hematoma and wound dehiscence. Late complications were observed in 12 patients (10.8%). All complications were addressed without consequence to the surgical outcome. No recurrence was observed.
  
  
  CONCLUSIONS
  The island technique is an effective, simple, and reliable surgical option to correct prominent ears. Its greatest advantages are the absence of recurrence and the minimal incidence of complications.
authors.affiliation: Pontifical Catholic University of Rio de Janeiro, Carlos Chagas Post-Graduate Medical Institute, Brazil. jpmaricevich@hotmail.com
authors.forename: Pablo
authors.initials: P
authors.lastname: Maricevich
authors.forename: Natale F
authors.initials: NF
authors.lastname: Gontijo de Amorim
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Duprat
authors.forename: Franciele
authors.initials: F
authors.lastname: Freitas
authors.forename: Ivo
authors.initials: I
authors.lastname: Pitanguy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002356:Cartilage / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004431:Ear, External / Q000002:abnormalities / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D055815:Young Adult