The prominent ear, also called cup ear or bat ear, is so named as its appearance is like a cup or bat wing. It is mostly sporadic; in a few cases, it is hereditary or arises from a genetic deformity. Typical manifestations are aplasia of the pinna cartilage, and the whole ear has a deep conchal bowl appearance lacking the shape of the helix or antihelical (Y shape) fold. Further, the weak ear cartilage is unable to support the entire ear in having a normal angle; ear configurations appear prominent when viewed from the front. The normal angle of the anteverted pinna and the head (extroverted angle) should be less than 30°. If this exceeds 45°, it makes the ear protrude beyond the facial contour, and this should be corrected by otoplasty.
This surgery brings the angle back to the normal range and sculpts a normal helix. A 2-cm incision is made at the back of the ear to detach the skin from the auricular cartilage, and the flat auricular cartilage is longitudinally dissected and partially removed. Then, both ends of the incised cartilage are sculpted and stitched with a non-absorbable suture based on the shape of the helix, and meanwhile, the overall pinna is fixated in the retro-auricular direction. In this way, the originally extroverted angle is reduced to a normal range, but the pinna angle needs more time to be adjusted to ensure the symmetry of both ears.