Answer:
The constricted ear represents a group of anomalies in which the encircling helix seems tight as if it were constricted.
To fix it, one must either:
1) reshape the existing tissues, or
2) supplement skin coverage and/or supporting cartilage
What you do depends on the degree of deformity...
A) Minimal deformity with helical lidding and minimal height discrepancy - excise overhanging tissue.
B) Moderate - If there is a height discrepancy, you need to augment cartilage height by modification of the ipsilateral ear cartilage or contralateral cartilage grafts. But first, you need to visualize the defective cartilage after degloving the skin envelope
C) Severe deformity with height difference of greater than 1.5 cm. Add both skin and cartilage as if it were a formal repair.
Tanzer's Classification:
I. Anotia
II. Complete hypoplasia (microtia)
A. With atresia of the external auditory canal
B. Without atresia of the external auditory canal
III. Hypoplasia of the middle third of the auricle
IV. Hypoplasia of the superior third of the auricle
A. Constricted (cup or lop) ear
B. Cryptotia
C. Hypoplasia of the entire superior third
V. Prominent ear