Advanced reconstruction of the ear: a framework for successful wound closure.

BACKGROUND: The ear is a complex and intricate feature of the human face in which reconstruction after oncologic excision is predicated on the complete removal of skin cancer. Reconstructive strategies are based on an understanding of the hierarchy of aesthetic concerns for the ear.

METHODS: Review of the reconstructive strategies for reconstruction of the ear.

RESULTS: The 2 most important characteristics of the ear are its symmetrical projection from the head and the smooth curvature of the helix. With this in mind, the reconstructive plan must begin from the "inside out" with assessment of the cartilaginous frameworks followed by the cutaneous defect.

CONCLUSION: A reconstructive strategy that takes into account the hierarchy of aesthetic concerns for defects of the ear will optimize cosmesis, function, and patient's satisfaction.