The placement of the face-lift incision behind the tra-gus reduces the appearance of the preauricular scars; however, a few important points must be kept in mind. Avoiding tension on the skin flap will prevent the distortion of the tragus, which is pulled forward and leaves the ear canal open. Although it might be necessary to defat the flap going over the tragal cartilage, excessive defatting will lead to skin necrosis: thus the maneuver should be done with care. Before suturing the skin flap, which should be rounded or rectangular, it is a good technique to defat the anterior portion in front of the tragus and in front of the auricular canal in an attempt to allow a depression to be created in front of the tragus, keeping a natural
look. If this technique is not performed, an unnatural look of the pretragal area will result, taking away the advantages of the postauricular tragal scar.
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