earAbstractBackground: Cartilage-cutting and cartilage-sparing techniques are the two types of otoplastyprocedures. Because of the significant risk of haematoma, skin necrosis, and ear deformity,cartilage-cutting techniques have been questioned. As a result; suture-based cartilage-sparingprocedures such as Mustarde and Furnas suture procedures have grown in popularity. However,these techniques have a tendency for deformity recurrence due to cartilage memory and suturefatigue, as well as the possibility of suture extrusion and pinpricking sensation of the sutures.Methods: In this study, we used a medially based adipo-dermal flap including perichondriumwhich is elevated from the back of the auricle to cover and support a cartilage-sparing otoplasty,thirty-four patients (14 female and 20 male) were operated using this technique. The mediallybased perichondrio-adipo-dermal flap is advanced anteriorly and fixed to the helical rim undercover of the distal skin flap. This procedure sought to cover the suture line preventing sutureextrusion and support in the repair of the deformity preventing its recurrence.Results: The average operative time was 80 min, ranging from 65 to 110 min. The patientspassed the early postoperative period uneventfully except for 2 patients; one patient (2.9%)developed haematoma, and the other patient developed a small area of necrosis on the newantihelical fold. In late the postoperative period recurrence of the deformity developed in onepatient. No patients developed suture extrusion or granuloma.Conclusion: The treatment to repair prominent ears is easy and safe, with benefits such asa natural-looking antihelical fold and minimal tissue stress. The medially or proximally basedadipo-dermal flap may help to lower recurrence rates and suture extrusion.© 2021 Sociedad Espa˜nola de Otorrinolaringolog´ıa y Cirug´ıa de Cabeza y Cuello. Published byElsevier Espa˜na, S.L.U. All rights reserved.