Maintaining an acceptable cosmetic appearance after excision of lesions of the external ear poses a challenge for plastic surgeons, because of the ear's intricate anatomical structure. Primary side-to-side closure following wide composite excisions of the helical rim and the central ear significantly decreases the vertical height of the ear. When the lesion is large and extends into the conchal cartilage, side-to-side closure often ensues in characteristic deformities such as cupping, telephone ear deformity and notching of the helical rim. These events lead to poor post-operative cosmetic results.
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