Patient’s age

Patient’s goals and expectations

History of prior surgery to ears

History of prior ear trauma

History of poor wound healing (e.g., prior keloids)

Presence/absence of preoperative asymmetry

Overall size and shape of ear

Helix–mastoid angle

Helix–mastoid distance (upper, middle, and lower thirds of the ear)

Cartilage consistency

Characteristics to be evaluated (Fig. 19-1)

• 
  

  Upper third of the ear

  
  
  
  
  • 
    

    Underdeveloped/deficient antihelical fold

    
    
  • 
    

    Obtuse scaphoconchal angle (>90 degrees)

  
  
• 
  

  Middle third of the ear

  
  
  
  
  • 
    

    Conchal hypertrophy (concha cavum >1.5 cm deep)

    
    
  • 
    

    Obtuse conchal–mastoid angle (>25 degrees)

  
  
• 
  

  Lower third of the ear

  
  
  
  
  • 
    

    Large, prominent lobule

    
    
  • 
    

    Position of lobule