cartilage that is covered, on its visible surface, with thin, tightly adherent, hairless skin. Although of small area, the surface anatomy of the external ear is complex, consisting of the pinna (the auricle) and the external auditory meatus (auditory canal). The outer framework of the pinna is composed of the rim of the helix, which arises from the front and from below (anteriorly and inferiorly), from a crus (shank) that extends horizontally above the auditory canal. The helix merges downwards (inferiorly) into the cauda helices (tail of the helix), and connects to the lobule (earlobe). The region located between the crura (shanks) of the antihelix is the triangular fossa (depression), while the scapha (elongated depression) lies between the helix and antihelix. The antihelix borders in the middle (medially) to the rim of the concha (shell) and the concha proper, which is composed of the conchal cymba above (superiorly) and the conchal cavum below (inferiorly), which are separated by the helical crus, and meet the antihelix at the antihelical rim. The tragus (auditory canal lobule) and the antitragus (counterpart lobule) are separated by the intertragal notch; the auditory canal lobule does not contain cartilage, and displays varied morphologic shapes and attachments to the adjacent cheek and scalp. Blood supply and innervation The superficial temporal and posterior auricular arteries preserve the arterial blood supply of the external ear. The sensory innervation involves the front and back (anterior and posterior) branches of the greater auricular nerve, and is reinforced by the auricular temporal and lesser occipital nerves. The auricular branch of the vagus nerves supplies a portion of the posterior wall of the external auditory canal. Otoplastic praxis The support framework of the reconstructed pinna must be more rigid than the natural cartilage framework of a normal ear, in order for it to remain of natural size, proportion, and contour. If the reconstructed pinna framework were as structurally delicate as the cartilage framework of a natural pinna, its anatomic verisimilitude as an ear would gradually be eroded by a combination of the pressure of the tight skin-envelope in the temporal region of the head, and of the pressure of the progressive contracture of the surgical scar(s). Prominent ears In the practice of otoplasty, the term "prominent ears" describes external ears (pinnae) that, regardless of their size, protrude from the sides of the head. The abnormal appearance exceeds the normal head-to-ear measures, wherein the