There are two primary reasons for some ears to be more prominent than others. The first is because there is an overgrowth of the cartilage that forms the sunken portion of the ear as seen from the front. This is known as the “conchal bowl” and the condition is called “conchal hypertrophy” which causes the entire ear to stick out. The second condition, which causes mostly the upper portion of the ear to protrude, occurs because of a failure of a particular fold of the ear to form during development. The outer edge of the ear is referred to as the helical rim. Just inside the rim is a prominent fold known as the antihelical fold. As this fold runs up towards the top of the ear, it splits in two forming a curved “Y” shape. The upper limb of the “Y” is called the superior crus which is the fold that sometimes is deficient or absent causing the upper portion of the ear to stick out.