A clinically proven piston design in a well-tolerated material-titanium. The opening in the bucket of the prosthesis is modified to allow the incus to assume its correct anatomical position, minimizing the danger of pressure necrosis. The bucket handle fits easily over the lenticular process, eliminating any need for crimping and the postoperative chances of pressure necrosis. The bucket handle prosthesis fits either the left or right ear. A hole in the posterior bucket allows for pick insertion to aid in positioning. Two transaxial holes in the distal end of the prosthesis stem allow for tissue ingrowth to aid in the stabilization of the implant.