Minimally invasive otoplasty (MIO) is an elegant and well-proven technique for correcting protruding ears as the most frequent form of first-degree auricular dysplasia. It is well suited for the majority of patients with prominauris who regularly present to a facial plastic surgery practice. Although there are several variations of the MIO, all MIO techniques differ from traditional otoplasty techniques in that they avoid a large retroauricular skin incision and excision. This distinction considerably diminishes the risk of hypertrophic scars and keloids. The best elements of traditional otoplastic techniques can be utilized with much smaller incisions, respectively, even without incisions at all and with new surgical instruments to achieve an effective and precise surgical result. The MIO technique described herein enables all steps of cartilage work through the small retroauricular skin incision that Kaye already suggested in the very first publications of a closed otoplasty technique 1967.