Aesthetic Auricle Reconstruction with the Dieffenbach Flap: A Retrospective Case Review

The Dieffenbach flap is often used for post-Mohs reconstruction of auricle defects, effectively restoring the auricle rim. However, its impact on auricle projection and length after division and inset is not well-documented. This study evaluates auricle projection and length following defect repair with the Dieffenbach flap, comparing results to the non-operative ear. We conducted a retrospective review of patients who underwent a Dieffenbach flap repair surgery at a single institution from 2016 to 2023. Auricle projection and length of the reconstructed ear were measured within the first month following division and inset of the flap and compared to the contralateral ear. A subset of patients had additional measurements > 1 month following division and inset, and these measurements were compared to the contralateral ear. Our study included 23 patients with an average age 67.4 years and 78.3% male. Within one-month following division and inset, the Dieffenbach flap resulted in a significant decrease in auricle projection (16.5mm vs. 18.6mm, p <0.05) and length (67.0mm vs. 69.7mm, p <0.05) compared to the contralateral ear. Subsequent follow-up showed no significant differences in projection (18.5mm vs. 18.5mm, p = 0.98) or length (68.0mm vs. 68.7mm, p = 0.54). Following division and inset of the Dieffenbach flap, auricle projection and length experience initial reduction but subsequently self-correct to match the contralateral ear.