We present the resolution of a case of a 50-year-old patient who presented for excision and reconstruction of a malignant skin lesion at the auricular tubercle of the right helix. The patient reported great concern for the aesthetic outcome. The auricular helix has a unique projection, relief, consistency, and size determined by the contralateral side. Its reconstruction is a surgical challenge and requires sophisticated techniques to achieve good results. Therefore, in cases where we are looking for precision and predictability, 3D technology is a great help for the surgeon as it allows pre-surgical patient-specific planning and the printing of sterilisable models that serve as surgical 3D guides. This case was solved with a two-stage reconstruction. First, the lesion was excised, and a retro auricular advancement flap was placed. In the second stage, the placement of cartilage was sectioned using a customised surgical model obtained from the scanning of the contralateral ear surface. This way, the cartilage donor area was optimised, choosing the most similar shape and size with great precision.
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