The patient presented with a pedunculated keloid arising from the upper helix and posterior surface of the auricle, approximately 2 cm in diameter and projecting outward beyond the natural ear silhouette. An adjacent stud earring was in place, suggesting the lesion had developed from a previous helical piercing. Treatment was complete excision under local anaesthesia, with care taken to preserve the helical cartilage framework and a layered closure aligned with the rim. The follow-up image shows the bulky mass entirely removed and the helical curvature restored, with mild residual pink coloration in the early healing phase that will mature over the months ahead. Performed by Dr. Pongsak at Pongsak Clinic, Hua Hin Road 55.