There is considerable variation in ear shape.
That one's a bit unusual, but I've seen one - a good number of years ago, so surgery is extremely unlikely - where the ear was so thin it was translucent and the tubercle (which was unusualy open, almost flat) followed the leaf form so perfectly it had to be real. And the veins (this was a very translucent ear) followed as well.
People come in a lot of different shapes...