ABSTRACT
The ear is a complex shape and special approaches are needed to retain that shape wherever possible. Small lesions on the rim or antihelix can be removed and sutured easily. Sometimes there is minimal distortion but it is often not noticeable as both ears are not usually seen at the same time. Wedge excision and helical rim advancement reduce the circumference of the ear but this is not readily noticeable. Sometimes the join can be obvious when cartilage of different thicknesses are brought together. The ear may fold forward to some extent. Indentation at a join line is called a butterfly deformity. Direct skin-to-skin closure leaves the length of the ear unchanged but gives an odd shape. A pedicle flap is another method used to repair a defect on the rim of the ear. It can only be used if there is a large enough area without hair adjacent to the part of the rim to be repaired.
