**Translation:**
After the auricle is subjected to compressive or pinching closed injuries, subperichondrial hematoma forms due to bleeding, leading to ischemic necrosis such as cartilage necrosis. As the hematoma undergoes organization, fibrous connective tissue hyperplasia and contraction occur along with cartilage necrosis and other pathological changes. Gradually, the auricle thickens and shrinks, presenting many irregular protrusions on its surface. Between these protrusions are folds of varying depths, resembling a cauliflower. It feels hard and resilient to the touch, often accompanied by tenderness, and is referred to as "cauliflower ear." Burn injuries or secondary purulent infections during ear acupuncture that lead to untreated chondritis can also easily result in cauliflower-shaped auricle deformities.
**What is Cauliflower Ear Plastic Surgery?**
The treatment of cauliflower ear is relatively difficult and it is not easy to achieve good results. Surgery should be performed after the inflammation has completely subsided and the condition has stabilized, which usually takes at least about half a year. The surgery involves stripping the skin from the cartilage to form a skin flap, exposing the thickened fibrous tissue and deformed cartilage. The cartilage is appropriately thinned, and then loosened or sculpted into shape to restore its original anatomical structure. Since the range of the skin flap cannot be too large to avoid necrosis due to blood circulation disorders, it often requires multiple surgeries to complete the correction of cauliflower ear. For cases where there is significant cartilage necrosis but relatively loose skin, autologous costal cartilage transplantation can be used to reconstruct the ear framework for repair. If there is also insufficient skin, ear reconstruction surgery may be considered according to the situation.
**Cauliflower Ear Plastic Surgery Methods:**
The plastic surgery for cauliflower ear deformity is an extremely challenging procedure, generally conducted after the inflammation has completely dissipated and the condition has stabilized. An incision can be made 0.5 cm away from the helix edge on the anterior outer side of the auricle. Carefully, a skin flap is formed by stripping between the uneven skin and cartilage. Once the deformed cartilage is exposed, the thickened cartilage is appropriately thinned, loosened, flattened, or carved into shape to conform to the original anatomical structure. Finally, the lifted skin flap is smoothed and covered over the trimmed cartilage, with excess portions being removed. After suturing the incision, cotton balls or soft gauze are used to fill and press according to the convex and concave shapes of the auricle. The range of the skin flap cannot be too extensive, otherwise, necrosis may occur due to blood circulation problems. Therefore, it often requires several surgeries to complete the correction of cauliflower ear, and the final surgical results are often disappointing. Clinically, almost no perfectly restored cases have been seen.
In severe cauliflower ear deformities, although there is significant cartilage necrosis, the skin tissue is often relatively loose. Thus, autologous costal cartilage transplantation can be applied to reconstruct the ear framework for repair. For cauliflower ears with relatively insufficient skin, since the earlobe part is often intact, the deformed upper part of the auricle can be removed while preserving the earlobe for auricle reconstruction surgery.