Microtia (small or absent ear)
Ear reconstruction, can provide a positive solution for cases where a child is born with a tiny, malformed ear (which is called microtia), and also the traumatic loss of an ear through accident.
For children who were born with an underdeveloped ear, cosmetic surgery can begin as early as age six. Older patients can be benefitted immediately following the accidental loss of an ear. In all cases, the most effective method for success will be achieved by carving a new framework from the patient’s own rib cartilage. Atresia refers to the absence of the external canal, which is almost always associated with microtia. If the internal components are developed well enough, an external ear canal can be created. This, however, should not be done until the external microtia repair has been completed.
While there are a number of synthetic frameworks available, these are not living material, and the chance that the will erode through the skin is high. When this happens, the artificial framework has to be removed, and the patient will have lost their chance for a successful ear reconstruction.
A living ear created from the patient’s own tissue, when done well, is preferable to a stick-on prosthetic. The quality of the result depends upon your surgeon’s artistic ability to carve, or sculpt the cartilage.
7 year-old girl with classic Grade III Microtia with Atresia
The left ear is the reconstructed ear
The process begins by using a mirror image of the patient’s normal ear as a template. Measurements, patterns, molds, and plaster casts are made from this mirror image, and the surgeon carefully chooses where the new ear will be created under the existing skin.
During surgery, a carefully carved cartilaginous framework of the patient’s own cartilage is implanted beneath the skin. If an earlobe is present, it will be rotated into the proper position. Once this has been allowed to heal, the ear is elevated, and a skin graft is placed behind the cartilage in order to create the space behind the ear, and help bring the reconstructed ear out. Finally, the central cup, or concha, is deepened and the protective door over the canal, or tragus, is created.
If the patient has sufficient internal hearing structures, it may be desirable to create an external auditory canal. Creation of the external ear, however, must be completed before a canal is made.
A patient can be missing an ear as the result of congenital causes, trauma, or malignancy. Congenital, or developmental absence or deficiency of an ear can be the result of a number of syndromes. This includes Hemifacial Microsomia, the First and Second Branchial Arch Syndrome, Goldenhar's Syndrome, Plagiocephaly, and other syndromes. Microtia from the above causes is best reconstructed using a framework made from the patient's own rib cartilage. Non-living materials for ear reconstruction, although readily available, MUST be avoided. They will fail. When extrusion of these non-living materials occurs, it results in infection, intense scaring, and severe deformity. Reconstruction following this situation is difficult, if not impossible. At Fairbanks Plastic Surgery, however, we have been able to salvage a good percentage of failed ear reconstructions.
For the traumatic injury, many reconstruction techniques are available, including the rib cartilage approach that is standard for microtia. Local flaps and cartilage grafts from the opposite ear can also be used where appropriate. For ears lost from malignancy, the resulting scarring usually precludes reconstruction surgery and a prosthesis (a detachable, non-living, plastic ear) is generally required.
Your plastic surgeons at Fairbanks Plastic Surgery Center have extensive experience and expertise in performing total ear reconstruction using autogenous living tissues. As a result of their artistic background and ability, they have successfully produced some of the most natural appearing results available in ear reconstruction today. As a result, patient satisfaction is high.
All post-operative pictures are of real patients of Fairbanks Plastic Surgery. Identifiable images are used with patient permission.
Reconstruction for Microtia
Microtia/Atresia Before and After Reconstruction
Reconstruction For Microtia
Reconstruction After Road Trauma
Reconstruction Surgery After Trauma
Microtia Repair With Cartilage Grafts
Deformity With Plagiocephaly
Your surgeons at Fairbanks Plastic Surgery Center of Utah have extensive experience and expertise in performing these procedures. Every care and attention will be taken to maintain your health and well-being while providing you the optimal result from your Cosmetic Plastic Surgery operation.
For more information and to schedule a consultation, please call the Fairbanks Plastic Surgery Center at (801) 268-8838.