Tragal Cartilage Contouring During Facelift Surgery: A Novel Technique for Prevention of Postoperative Tragal Distortion.

[PURPOSE] To describe a novel technique of tragal cartilage contouring during facelift surgery and evaluate its effectiveness in preserving tragal contour and preventing postoperative tragal deformities.

[METHODS] A retrospective chart review was performed of patients who underwent rhytidectomy with tragal cartilage contouring between January 2022 and December 2023 by a single surgeon. Following flap elevation and repositioning, the cephalic tragal rim was trimmed, vertically scored, then contoured with a horizontal mattress suture to support a convex surface postoperatively. Overlying soft tissue was anchored to the superficial musculoaponeurotic system to reduce tension. Standardized pre- and postoperative photographs were evaluated by 3 independent, blinded, oculoplastic surgeons using a 4-point Likert scale to assess tragal contour, peritragal contour, scar visibility, and overall aesthetic result. Patients also provided subjective ratings of their aesthetic outcome.

[RESULTS] Twenty-eight patients (24 women, 4 men; mean age 62 years, range 51-74) were included, with a mean follow-up of 8 months (range, 4-12). Independent reviewers rated all tragal contour outcomes as "good" or "excellent," with no cases rated "fair" or "poor." All patients rated their aesthetic outcome as "excellent." No complications or secondary interventions occurred.

[CONCLUSIONS] Tragal cartilage contouring is an effective technique that can be performed during rhytidectomy. By addressing cartilage shape and tension distribution, this method preserves tragal contour and prevents common postoperative deformities, supporting consistently favorable aesthetic results.