Ear Reconstruction Surgery for Microtia
Rebuilding the shape of the outer ear so you can feel more at ease around other people and in everyday conversation.
Is this right for you?
Microtia is a condition in which the outer ear, the ear canal and the middle ear are underdeveloped. It can affect both hearing and the appearance of the ear. The degree varies widely, from a partly formed ear to almost no ear at all. Whether you or your child is a good fit for surgery depends on how the ear is affected, on age, and on overall health. We work this out together during an in-person assessment.
This may be a good fit if
- Children roughly 6 to 8 years old, the age at which the ear cartilage has reached about 85 to 90 percent of adult size and the rib cartilage is large enough to build the framework of the ear
- People with a partly or fully underdeveloped outer ear due to congenital microtia
- People in stable general health who are well enough to undergo surgery and anesthesia
- People who have been examined by a plastic and reconstructive surgeon and an ear, nose and throat specialist, with hearing tested and ear structures checked so the condition can be assessed accurately
This may not be right if
- A child is still too young, when the rib cartilage is not yet large enough to build the framework of the ear
- You have an underlying condition or a state of health that would make surgery and anesthesia unsafe
- Your hearing and the structure of the outer and middle ear have not yet been fully checked to decide on the right plan
- You are expecting an ear that matches the healthy side exactly after a single operation
How it works
Everything begins with an examination and a consultation. You will meet a plastic and reconstructive surgeon and an ear, nose and throat specialist. They test your hearing, assess the structure of the outer and middle ear, and talk with you in detail about the condition and how it can be treated. You also have routine tests to check your health before surgery, along with a CT scan of the skull and face.
The ear can be rebuilt in two ways: using your own cartilage, or using an implant. With your own cartilage, the surgeon takes rib cartilage from your body and shapes it into the framework of the ear. This material is readily available, suits your body, and carries a lower risk of infection. With an implant, the surgeon uses a framework made from porous polyethylene (Medpor), wraps it in a flap of tissue from the temple, and covers it with a skin graft.
The number of operations depends on the method. The implant method usually needs only one operation. The rib cartilage method is carried out across two operations. Each operation lasts about 2 to 3 hours and is done under general anesthesia. Your surgeon will explain which approach makes more sense for your particular situation, along with the advantages and limits of each.
Before surgery, you need to avoid aspirin, certain anti-inflammatory medicines, and herbal supplements that can raise the risk of bleeding. Your doctors will guide you through getting ready and tell you what to keep in mind in the days before the operation.
Realistic expectations
Ear reconstruction is a journey that takes time and usually happens in several steps, rather than an instant change. The goal is to rebuild the shape of the ear so you feel more comfortable in everyday conversation.
What this will not do
- This surgery focuses on the shape of the outer ear. On its own it is not a way to restore hearing, and any problems with the structure and function of the ear canal and middle ear need to be assessed separately
- Your doctors will not promise an ear that matches the healthy side in every detail
- With the rib cartilage method, the process is not finished in a single session, because it takes two operations
Recovery
The recovery times below are rough estimates and can differ from one person to the next, depending on the method and on your body. Your doctor will follow your progress closely and adjust the guidance to suit you.
- In hospital
- Each operation usually calls for a hospital stay of about 5 days for monitoring.
- The first 1 to 2 weeks
- This is the early recovery period after each operation. You will need to protect the surgical area as your doctor advises.
- Between operations
- With the rib cartilage method, the reconstruction is completed across two operations, so there is a planned waiting period between them, set by your doctor.
Risks & safety
As with any surgery, ear reconstruction carries risks tied to anesthesia and to the operation itself. Understanding these before you decide is an important part of the process.
- Drug allergy and complications related to anesthesia
- A collection of blood or fluid at the surgical area
- Infection; this risk is noted to be higher when an implant is used
- Rejection of the material, particularly with the implant framework method
- Poor scarring at the ear or at the site where cartilage is taken
- Death of the grafted skin, which has been noted with the implant method
- With the rib cartilage method, complications can occur at the donor site, such as air or blood collecting around the lung
How we do it
At The Gioi Dep, the preparation is done carefully before surgery is even discussed. You are examined and advised by a plastic and reconstructive surgeon together with an ear, nose and throat specialist. Your hearing is tested, the structure of the outer and middle ear is assessed, routine tests are carried out, and a CT scan of the skull and face is taken, so the condition is well understood before a plan is made.
Your doctors talk openly with you about both routes for rebuilding the ear, using your own cartilage or using an implant, along with the advantages and limits of each. With the rib cartilage method, the work is carried out across two planned operations, so the cartilage framework of the ear is built and shaped step by step.
Frequently asked questions
What age is right to begin ear reconstruction?
The right age to begin is usually 6 to 8 years old. By then the ear cartilage has reached about 85 to 90 percent of adult size, and the rib cartilage is large enough to build the framework of the ear. Your doctor will assess each case individually.
How many operations are needed?
It depends on the method. The implant method usually needs only one operation. The method that uses your own rib cartilage is carried out across two operations.
How long does one operation take, and how many days in hospital?
Each operation usually lasts about 2 to 3 hours, depending on the method. The hospital stay for each one is around 5 days for monitoring.
How long is recovery?
Early recovery after each operation takes about 1 to 2 weeks. This is a rough estimate and can differ from one person to the next; your doctor will give you guidance tailored to you.
Will ear reconstruction help me hear better?
This surgery focuses on rebuilding the shape of the outer ear. Microtia can come with differences in the structure and function of the ear canal and middle ear, so hearing needs to be checked and assessed separately. Share what you are hoping for with your doctor during the consultation.
Will the new ear look natural?
The goal is to rebuild the shape of the ear so you feel more comfortable in everyday conversation. Your doctors will not promise an ear that matches the healthy side in every detail. What you can expect is discussed based on how the ear is affected and the method chosen.
Should I choose my own cartilage or an implant?
Each approach has its own advantages and limits. Your own cartilage is taken from your rib; the material is readily available, suits your body, and carries a lower risk of infection, but there can be complications at the site where the cartilage is taken. An implant can be done earlier and reduces the number of operations, but the risk of infection and rejection is higher. Your doctor will advise on the choice that makes sense for your situation.
What risks should I know about beforehand?
Possible risks include drug allergy and complications from anesthesia, a collection of blood or fluid, infection, rejection of the material, and poor scarring. With the rib cartilage method, complications can also occur at the donor site, such as air or blood collecting around the lung. Your doctor will explain these clearly before you decide.
What do I need to prepare before surgery?
You are examined and advised, your hearing is tested, routine tests are done, and a CT scan of the skull and face is taken. You also need to avoid aspirin, certain anti-inflammatory medicines, and herbal supplements that can raise the risk of bleeding. Your doctors will give you specific guidance.
What causes microtia?
The cause is still not well understood. Genetic and environmental factors are thought to play an important role. Taking certain medicines during the first three months of pregnancy, such as Thalidomide or Accutane, has also been noted as a possible factor.
The next step
The next step is a conversation - book a consultation.
The content on this page is for reference only and does not replace a direct examination and consultation with a specialist physician. Surgical outcomes vary from person to person.