What Is Ear Reconstruction Surgery for Microtia?

What Is Ear Reconstruction Surgery for Microtia?

Ear reconstruction is one of the most rewarding surgeries in craniofacial care. Here is what families should know.

Ear reconstruction surgery creates a new external ear for children born with microtia. The two main approaches are rib graft reconstruction and Medpor implant.

Rib graft reconstruction (autologous):

• Stage 1 (age 6–10):
• Cartilage is harvested from the child's rib cage (one side)
• The cartilage is carved into the shape of an ear
• It is placed under the skin on the affected side
• The child stays in the hospital 3–5 days

• Stage 2 (4–6 months later):
• The ear is lifted away from the head
• A skin graft is placed behind the ear
• This creates the natural ear fold

• Stage 3 (optional, for lobe creation):
• The earlobe is created or moved into position

• Advantages:
• Living tissue (feels natural, grows with the child)
• No foreign body
• Very durable (strong enough for sports)
• Lifelong result

• Disadvantages:
• Requires rib harvest (chest scar)
• 2–3 separate surgeries
• Cannot be done before age 6

Medpor implant:

• A synthetic ear-shaped implant is placed under the skin
• Usually a single surgery
• Can be done at age 3–5
• No rib harvest needed

• Advantages:
• Starting age is younger
• Single surgery
• No chest scar

• Disadvantages:
• Synthetic material (risk of exposure or infection)
• Less natural feel
• Not as durable as rib cartilage

Clinical Guidance

Ear reconstruction for microtia is performed using either rib cartilage (autologous) or a synthetic Medpor implant. Rib graft reconstruction uses the child's own tissue and is very durable but requires multiple surgeries. Medpor is a single-surgery option but uses synthetic material.