In this paper, the complete procedure to design and construct reusable moulds for implant-based ear prosthesis and manufacture substructures by means of a computer aided design-computer aided manufacturing (CAD-CAM) procedure and rapid prototyping (RP) technology is presented. The scan of the healthy ear, the virtual superimposition of its mirrored image on to the defective side, and the rapid manufacturing of the substructure and of the mould eliminate several steps of traditional procedures (wax, stone, try-in). Moreover, the precise design and customization of the substructure is presented, with the original and engineered shape for the retention of the silicone. The time and cost saving results of this protocol are presented together with a discussion of the main design features that make the prosthesis a stable and reproducible system to improve rehabilitation of patients with auricular defects or absence.