Being the deficiencies in the formation or deepening of the antihelix crease the main cause for ears sticking out, some cases also suffer from excessive length of the so called ear stem or concha bowl, which pushes far from the head the whole ear making it too visible.
Through the same retroauricular access practiced to perform the pinning otoplasty a crescent of ear concha cartilage can be removed to shorten the distance between the ear and the scalp, with suture assemble to maintain ear support.