Background: This San Francisco man came into our office for a consult about his prominent ears. He wanted to bring the ears... closer to his head, although, not pinned to his head. He was wanting to wear his hair short so he would not need to hide his ears. Used computer imaging to illustrate how he wanted his ears to appear after surgery. The most common cause of prominent ears is a poorly developed antihelical fold. This fold is in the middle of the ear and causes the normal ear to face away from the head at a 25-30 degree angle. When this fold is not present, the ears don’t fold back and they face forward at a 90 degree angle from the head. The key in acheiving excellent results with otoplasty surgery is to bring the ear closer to the head, creating a 25 degree angle, but avoiding having it pinned to the head at a 0-10 degree angle. Having the ears to close may give an unnatural or operated appearance. Procedure: Otoplasty Follow-up: He is very happy with his results. His ears match his face, we were pleased with the improved symmetry.