Reconstruction
Ear Reconstruction
Restoring the Ear After Skin Cancer Removal
The ear is a frequent site for skin cancer — particularly on the helix (outer rim), antihelix, and earlobe, where years of sun exposure accumulate. Its complex three-dimensional anatomy, limited local tissue, and cartilage framework make ear reconstruction a unique challenge.
Dr. Skinner approaches ear reconstruction with the dual goals of restoring natural contour and ensuring the skin over the cartilage framework is well-vascularized and stable long-term.
Anatomy of the Ear
Understanding the specific location of a wound within the ear helps determine the best approach:
Helix
The prominent outer rim; the most common site for ear skin cancers
Antihelix
The curved ridge inside the helix
Scapha
The groove between helix and antihelix
Concha
The deep bowl of the ear; skin here is thin and adherent to underlying cartilage
Tragus
The small projection in front of the ear canal
Earlobe
The soft, cartilage-free lower portion; highly amenable to reconstruction
Reconstruction Techniques for the Ear
Second Intention Healing — Conchal Bowl
The conchal bowl is a notable exception to the usual surgical approach: wounds in this concave area often heal beautifully on their own, with minimal scarring. Second intention healing is often the first choice for conchal bowl defects.
Helical Rim Advancement Flap
For defects along the helical rim, the elastic properties of the ear allow the remaining helix to be advanced around the curve to close the defect. The ear may be slightly smaller but retains its natural shape. An excellent option for small to medium helical defects.
Chondrocutaneous Advancement Flap
Advancing both the skin and the underlying cartilage together (as a composite unit) to close helical defects while preserving the natural rim contour. Requires careful planning and surgical technique.
Banner Flap / Transposition Flap
Local skin from the postauricular (behind the ear) area or immediately adjacent tissue can be transposed to cover defects on the antihelix, scapha, or helical root.
Full-Thickness Skin Graft (FTSG)
Postauricular skin is an excellent donor site for ear reconstruction — it matches the thin, color-consistent skin of the ear closely. FTSGs are commonly used for moderate-sized defects on the anterior ear surface.
Cartilage Grafting
When cancer removal requires excision of underlying cartilage, structural support must be restored. Auricular cartilage from the same or opposite ear can be used to rebuild the framework before skin coverage.
Earlobe Reconstruction
Earlobe defects following cancer removal — or following traumatic injury — can be reconstructed using multiple flap techniques that restore the natural rounded contour of the lobe, including the potential for earring wear after healing.
The Importance of Sun Protection on the Ears
The ears receive significant cumulative sun exposure but are frequently missed when applying sunscreen. Patients with a history of ear skin cancer should apply SPF 30+ sunscreen to the ears daily and wear hats with a full brim. Annual skin exams are strongly recommended.
Schedule a Consultation
Call our Alcoa office — same-week evaluation available for suspicious lesions.
(865) 268-4444