title: Correction of Lobule-type Microtia: Part 2: The Stage of Ear Elevation.
abstract: BACKGROUND
  Here, we introduce our recent operative technique for ear elevation that results in (1) minimal morbidity for patients, (2) symmetric appearance, (3) clearer 3-dimensional structure with a deep concha, (4) good aesthetic appearance by hiding the grafted area behind the ear, and (5) maintenance of deep temporoauricular sulcus and angle.
  
  
  METHODS
  After a skin incision, the ear is elevated with temporoparietal fascia underlying the cartilage. On the conchal area, undermining is performed just below the skin so that the deep concavity can be maintained. Scalp and neck skin behind the ear is undermined subcutaneously and lifted up cranially to hide the entire area of grafted skin behind the ear. The postauricular surface is covered by full-thickness skin from the lower abdomen. A protective splint is applied for 3 months while sleeping.
  
  
  RESULTS
  A total of 137 ears in 121 patients were corrected with our technique and followed up for at least 3 years. All of the scar tissue could be hidden behind the ear, an aesthetically excellent result.
  
  
  CONCLUSIONS
  Our technique made it possible to acquire an excellent and symmetrical shape of the ear. The important points in our procedure are as follows: (1) subcutaneous posterior undermining to enlarge the conchal cavity, (2) careful arrangement of the temporoauricular angle and auriculo-earlobe angle, (3) reduction in the area of temporally grafted skin to hide all scars behind the ear, and (4) protection of the ear to maintain the shape using a postoperative splint.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Sapporo Medical University school of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Yotsuyanagi
authors.affiliation: Department of Plastic and Reconstructive Surgery, Sapporo Medical University school of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Yamauchi
authors.affiliation: Department of Plastic and Reconstructive Surgery, Sapporo Medical University school of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Yamashita
authors.affiliation: Department of Plastic and Reconstructive Surgery, Sapporo Medical University school of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Yamada
authors.affiliation: Department of Plastic and Reconstructive Surgery, Sapporo Medical University school of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Kato
authors.affiliation: Department of Plastic and Reconstructive Surgery, Sapporo Medical University school of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Akiyo
authors.initials: A
authors.lastname: Suzuki
authors.affiliation: Department of Plastic and Reconstructive Surgery, Sapporo Medical University school of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Saito