to the biochemical breakdown and elimination (resorption) of the cartilage tissue by the patient's body. In 1964, Radford C. Tanzer (1921–2004) re-emphasized the use of autologous cartilage as the most advantageously reliable organic material for resolving microtia (abnormally small ears), because of its great histologic viability, resistance to shrinkage, and resistance to softening, and lower incidence of resorption. The development of plastic surgery procedures, such as the refinement of J.F. Dieffenbach's ear surgery techniques, has established more than 170 otoplasty procedures for correcting prominent ears, and for correcting defects and deformities of the pinna; as such, otoplasty corrections are in three surgical-technique groups: Group I - Techniques that leave intact the cartilage support-framework of the ear, and reconfigure the distance and the angle of projection of the pinna from the head, solely by means of sutures, as in the permanent suture-insertion of the Mustardé technique the Merck stitch method and the incisionless Fritsch otoplasty<ref>Fritsch, M.H. (1995). "Incisionless Otoplasty". Laryngoscope. 105, 1-11.</ref>Fritsch, M.H. (2004). "Incisionless Otoplasty". Facial Plastic Surgery 20, 267–70 for creating an anti helical fold: Mustardé technique: An open invasive method, whereby the retroauricular cartilage is extensively exposed, a part of the skin is excised, and mattress sutures are inserted. Merck stitch method: a minimally invasive method, by which the ear is no longer cut open and the cartilage is left completely intact. The mattress sutures are inserted in the ear through 2 to 3 small stab incisions on the back of the ear. Incisionless Fritsch otoplasty: It is a combination of the minimally invasive technique and the Stenström technique, whereby the cartilage on the front of the ear is scored with superficial incisions. Group II — Techniques that resect (cut and remove) the pertinent excess cartilage from the support-framework of the pinna, which then render it pliable to being re-molded, reconfigured, and affixed to the head at the projection distance-and-angle characteristic of a normal ear; the relevant procedures are the cartilage-incision Converse technique and the Chongchet–Stenström technique for the anterior-correction of prominent ears. Group III — Techniques that combine the excision of cartilage portions from the support framework of the pinna, in order to reduce the degree of projection and the distance of the external ear from the head. Surgical anatomy of the external ear The pinna The external ear (pinna) is a surgically-challenging area in terms of anatomy, composed of a delicate and complex framework of shaped