Otoplasty is a procedure in which prominent external ears (sticking out, or too big) are corrected. Both auricles (external ears) are rarely perfectly symmetrical, but sometimes the asymmetry is very evident. Under local anaesthetic (sometimes with medical sedation), a curved concave-convex incision is made in the skin on the back of the ear. The skin is loosened from the cartilage framework both behind and in front of it (a small incision is made in the cartilage itself). The cartilage is then shaped with non-absorbable suture stitches and, sometimes, part of it is removed. In severe cases of prominent ears, the concha (the part of the ear closest to the auditory canal) is anchored to the mastoid bone with sutures to guarantee better adhesion of the auricle to the cranium. The skin incision is then sutured. The result is permanent.