The slightest of such deformities is a tiplike enlargement of the outer and upper angle of the helix, most commonly unilateral. This has been termed “_fox ear_.” In this condition there is more or less loss of the curl of the helix, with flattening beginning well down in the fossa, extending upward, and terminating in a triangular cartilaginous tip resembling the ear of an animal, hence the name. The correction of this fault is quite simple. An incision somewhat larger than the base of the cartilaginous triangle is made under a local anesthetic about one fourth inch below and back of the line corresponding to the superior border of the helix. The cartilage is exposed through this incision and excised with a fine curved scissors without wounding the anterior skin of the helix, and the incision neatly sutured, leaving the now redundant skin to contract. In this manner the fault is corrected without any appreciable scar. The sutures can be removed in three or four days. In the correction of macrotia various surgical methods may be employed, yet none can be emphasized, as exclusively indicated, inasmuch as the enlargements may involve one or the other part of the pinna. The greatest fault with most of these ears lies in the overdevelopment of the triangular antihelix or that area lying posterior to the fossa of the antihelix and the fossa of the helix, although in many cases the greatest malformation is found in the concha itself. The following methods for operation are therefore given not so much for their individual merit, but to act as a guide in the selection of an appropriate election or modification for specific cases. =Schwartze Method.=—Schwartze advises and has obtained excellent results by removing a long elliptical piece of the entire thickness of the pinna, including both skin and cartilage, from the fossa of the helix, followed by the excision of a triangular section with its base corresponding to the outer border of the helix and its apex terminating well in the concavity of the concha. The scheme of procedure is shown in Figs. 129 and 130. The raw edges are brought together by fine silk sutures, which are made to pass directly through the cartilage, and tied carefully to prevent any change of the transfixed parts, which would mar the result of the operation more or less and necessitate further interference. The arrangement of the sutures and the disposition of the parts are shown in Fig. 131. [Illustration: FIG. 129. FIG. 130. FIG. 131. SCHWARTZE METHOD.] =Parkhill Method.=—Parkhill advises a semilunar incision from the fossa of the helix with a rhomboidal exsection of the helix, as shown in Fig. 132, and suturing the parts, as shown in Fig. 133. [Illustration: FIG. 132. FIG. 133. PARKHILL METHOD.] The tonguelike ends of the semilunar incisions must, of course, vary in length, according to the amount of tissue necessary to remove to facilitate accurate juxtaposition of the newly designed flaps.