BackgroundStandard methods of otoplasty may risk anatomical distortion. Previous work showcased a novel, cartilage-sparing technique. This study aimed to confirm the safety and effectiveness of the method in a larger cohort. MethodsThis retrospective study included patients undergoing otoplasty by a single surgeon using a single technique between January 2021 and December 2023. Eligible patients were aged above 5 years and had prominent or constricted or cup ears, forming a 2cm distance from the mastoid. Surgical techniques included novel key-point sutures. Minimum follow-up was 6 months. Data on demographics, risk factors, perioperative management, and complications were collected from patient records. ResultsA total of 288 operated ears (147 patients) were included. The mean age was 17 years and 91 (61.9%) were female. The mean duration of follow-up was 24.3 months. Postoperative complications were generally minor and included PDS suture exposure (n=16, 5.5%), manageable postoperative pain (n=8, 2.7%), self-resolving swelling (n=8, 2.7%), minor bleeding (n=7, 2.4%), and superficial skin complications (n=4, 1.3%). Infections occurred in 4 ears (1.3%) and were treated effectively with topical/oral antibiotics. Cases of partial release of the ear resolved without intervention (n=4, 1.3%). Only 4 (1.3%) ears experienced loss of correction, with options for reoperation available as needed. Analysis showed no significant age differences in postoperative complications, and a nonsignificant trend towards higher postoperative swelling in males compared to females (10.7% vs 2.2%; P=0.054). ConclusionsThe data confirms that this technique offers a safe and rapid cartilage-sparing otoplasty with minimal complications and low recurrence rates. It ensures long-lasting and aesthetically pleasing results for prominent ear deformities. Level of evidenceLevel III