Patients who have prominent ears because of conchal hypertrophy generally have some of the excess cartilage removed from behind the ear with or without permanent stitches to hold the remaining cartilage closer to the side of the head. Those patients who have prominence of the upper portion of the ears because of an incomplete or absent superior crus of the antihelical fold will have that fold recreated with a combination of permanent sutures and weakening (scoring) of the front of the cartilage to allow it to bend backwards. Many patients have both conditions and, therefore, have both procedures done. Both procedures are done through incisions behind the ears. An ellipse of excess skin is usually removed from that area along with a small muscle.