It's one of the distinguishing features of a mixed martial arts fighter; a puffed up ear that looks like a cauliflower. With the rise in popularity of mixed martial arts, these days, it's not just the pros getting it, it's anyone training in close contact sports like jiu jitsu, wrestling and judo.
"I know a lot of people who have it," said jiu jitsu student Justin Konia.
"It's a badge of honor. In the old days, you could tell how good a grappler is by how bad his cauliflower ear is," said O2 Martial Arts Academy jiu jitsu instructor Michael Onzuka.
"I first got this in wrestling practice when I was in high school. I didn't wear a head gear and my ear got rubbed," said Kyle Snyder-Olivares.
Snyder-Olivares has 2 bad ears. The local jiu jitsu champ regrets not going to the doctor when he knew something was wrong.
"I felt bubbles popping in my ear and it was immense pain. It's like someone taking a baseball bat and hitting you in the head," said Snyder-Olivares.
The unmistakable pain he felt is Perichondrial Hematoma or "cauliflower ear". It's when the skin of the ear tears, fills with blood and hardens into scar tissue.
"I see a lot of them with it. I'm noticing it more and more," said Dr. Byron Izuka.
Hawaii doctors Byron Izuka and Jim Scoggin are concerned that young athletes who like it for the tough guy image, might not be aware of the irreversible damage that comes with having the deformed ears.
"Long term, you can have problems with your hearing," said Dr. Izuka.
"If you decide you don't like it anymore, it could be very difficult to reconstruct. It requires a very serious plastic surgery procedure with the possibility of not having a normal ear again," said Dr. Scoggin.
So, what should athletes do? For starters, doctors say don't go on youtube and follow do-it yourself videos showing athletes how to drain a cauliflower ear. Doctors warn, taking matters into your own hands can lead to an infected ear. The best thing to do... is to see a doctor -- ASAP.
"An infected ear is a terrible problem and can lead to 6 or more days of being on antibiotics," said Dr. Scoggin.
Dr. Scoggin and Dr. Izuka say once you tear your ear cartilage, the chances of it happening again are pretty high. They stress, it's important to be seen by a doctor within the first few hours for proper treatment.
Athletes in training, meantime can do simple things to prevent themselves from getting cauliflower ear such as wearing a protective helmet or headgear. You can find them at any sporting goods store. Doctors say an ounce of prevention is worth a pound of cure. Snyder-Olivares takes the advice to heart.
"I suggest whoever wants to compete, to protect their ears...because you only have 2 ears your entire life and don't want to mess it up. I'm living with this for the rest of my life," said Snyder-Olivares.