Can a Darwin's Tubercle Be Removed Without a Scar Even when It's on an Uncurled Helix?

Thank you for your question. Darwin's tubercle is a congenital ear condition which often presents as a thickening on the helix at the junction of the upper and middle thirds. This is a normal anatomic variant present in about 10% of the population. If the appearance of this condition causes concern, it can be improved with a minor surgical procedure performed under local anesthesia in the office. Following surgery, the ear displays a more smooth contour. Any surgical incision leaves a scar by definition, but the incision site is usually not noticeable. This procedure may be performed on an uncurled helix.

A Darwin's tubercle would need to be removed surgically, no matter where the location is.  Any time an incision is made, a scar will form.  The important part about the incision is in making it as inconspicuous as possible.  In most cases on the ear, this can be normally be done.  

The answer is no, surgery cannot be performed without a scar.  The goal is that the deformity be corrected and the scar is camouflaged  enough to avoid detection.  This always includes the thoughtful placement of incisions, which can be completely out of site, hidden along shadows or natural curves, and performed meticulously enough to achieve excellent healing.  For a Darwyn's tubercle the incision would be made on the posterior surface of the ear and the tubercle excised after the skin was elevated anteriorly over the tubercle.  The skin on the posterior surface of the ear almost always heals favorably.

One of the mantras in plastic surgery is that every incision leads to a scar. With that said, proper placement of the incision and meticulous execution of the procedure and wound closure leads to scars that are imperceptible. I agree with Dr. Winkler that this can be approached from behind the ear and add that the incision can also be placed just inside the rim of the ear. Thus, there are a couple of different options to approach removal of a Darwinian tubercle that creates a scar that should not be noticeable to anyone but you and your plastic surgeon. To determine which approach would be ideal would require detailed photos or a consultation. I hope this information is helpful.Stephen Weber MD, FACSWeber Facial Plastic Surgery