THE PREAURICULAR PORTION OF THE RHYTIDECTOMY INCISION

Objective: To evaluate the best placement of the preauricular portion of the rhytidectomy incision in the female patient from the aesthetic point of view. Design: Blind, randomized review of close-up photograph s of the ear area in 36 patients after rhytidectomy. Setting: Office s urgical suite, accredited by Accreditation Association of Ambulatory H ealth Care. Participants: Two facial plastic surgeons and two plastic surgeons, all skilled rhytidectomy surgeons. Interventions: None. Main Outcome Measures: Participants received close-up photographs of the e ar area of 36 patients at least 6 months after rhytidectomy. Eighteen patients had posterior tragal edge incisions and 18 patients had pretr agal incisions. Cases were randomized. Participants were asked to rate the preauricular portion of the rhytidectomy incisions overall as to aesthetic results. The categories were excellent, good, average, accep table, and poor. Results: Results of surveys were collated. Three cate gories of results were determined: best, acceptable, and poorest. Post erior tragal edge incisions scored higher than pretragal incisions. Th ose incisions that scored in the best category tended to have a normal contour of the tragus and normal pretragal sulcus. Incisions that sco red in the poorest category tended to have a flat posttragal edge with obliteration of the pretragal sulcus. Conclusions: The incision at th e posterior edge of the tragus is preferred over the pretragal incisio n for female rhytidectomy patients except those with a large, prominen t or angulated tragus.