Microtia and Atresia Program

What to Expect With Reconstruction Surgery

Reconstruction with a rib cartilage

When using rib cartilage as the main source of tissue, ear reconstruction may be completed in one or two surgeries, approximately three to six months apart. The first surgery is longer and requires hospitalization. During the surgery, the ENT will:

• Harvest rib cartilage through a small chest incision
• Sculpt the cartilage into similar shape and size as the opposite ear
• Remove the existing ear cartilage and replace it with the new, sculpted cartilage

Patients will usually stay in the hospital for one to two days following surgery and will go home with a large, bulky dressing that will stay on until the follow up visit – typically one week later. Children usually return to school a week after surgery, and physical activities and water exposure may resume after four to six weeks.

After the first surgery, the ear will have a good shape, but it may appear too close to the head. After the swelling goes down, a second surgery is planned to make the ear “stick out” and look more natural. A very thin slice of skin from the scalp area behind the ear is then grafted on the back part of the ear. Surgery and recovery time are much shorter compared to the first stage.

Reconstruction with a 3D implant

Reconstruction using a 3D implant is completed in a single surgery. Some patients can be discharged home on the same day (outpatient surgery). Some patients spend the night in the hospital following surgery. During the surgery, the ENT surgeon will:

• Harvest a flap from the scalp to wrap around a customized ear implant
• Place skin grafts on the new ear 
• Join the new ear framework with the patient’s existing small ear 

The patient will go home with a blue silicone cast and removable ear covering. The patient will follow up around 2 weeks after surgery to remove the cast. Follow ups will occur every 1-2 weeks for the first month to monitor healing (either virtually or in-person visits).

Children can usually return to school a week after surgery. Participation in physical activity is limited until 4-6 weeks post op, and water exposure is limited until cleared by the surgeon (about 2 months).