The patient presented with extensive keloid scarring covering most of the upper helix and the posterior surface of the auricle — a thickened, cobblestoned plaque rather than a discrete nodule, with surface irregularity affecting both the rim and the area behind the ear. The treatment involved staged surgical reduction under local anaesthesia, with careful preservation of the underlying cartilaginous framework so the auricular shape would remain intact, and primary closure across the resurfaced areas. The follow-up photograph (taken several months post-procedure, with the patient wearing an earring again) shows a smoothly contoured ear with the helical curvature restored and only mild residual surface thickening at the treated zone. Performed by Dr. Pongsak at Pongsak Clinic, Hua Hin Road 55.