Aesthetics of the auricle and its implications for otoplasty and auricular reconstruction

Objective: Otoplasty is the most common aesthetic surgical procedure performed in children. The goals for auricular surgery and the proportions of an aesthetically pleasing ear appear to be based on the aesthetic opinions of individual surgeons rather than on evidence-based data. Our study aimed to determine whether identifying an aesthetically pleasing auricle is possible. Methods: We used digital photographs of 29 auricles, a standardized camera setup, a panel of 20 plastic surgeons, and a visual analogue scale (VAS). We then analyzed the scores assigned by the panel for mean, median, standard deviation, analysis of variance, Tukey-Kramer Multiple Comparison Test, and Top 5 rankings. Results: Ranking by the panel was statistically significant (p<0.000001). Conclusions: It is possible to statistically rank the aesthetics of auricles, although it is difficult to identify the structural details that made an auricle aesthetically pleasing.