The parotoid, also known as the ear flap, is located in front of, above, or below the ear screen and has a variety of shapes, from a small ear, to a half-moon shape, to a small fleshy column or a small round bag. The parotoid can be single or multiple and contains cartilage tissue and small blood vessels, with some having fistula openings next to the parotoid. Many people are reluctant to remove the secondary ear because of the traditional belief that it brings good luck to people, but tethered ears that affect the appearance can be surgically removed to improve the appearance. Most parotoidectomies are relatively simple and involve removing the parotoid from its root, along with the cartilage tissue and blood vessels it contains. The main concern with this procedure is to carefully suture the skin so that it does not affect the aesthetic appearance after surgery. In the case of a fistula, there are some special techniques for removing the fistula. Some people think that the secondary ear is connected to the nerve and are worried that removing it will affect the brain, but this is not true. Oculoplastic surgery and subtotal ear removal can be performed at the same time. In pediatric patients, general anesthesia is required for surgical procedures, and simultaneous surgery can reduce the number of anesthesia sessions.