Ear contour correction here refers to reconstruction of an underdeveloped (microtia) or absent (anotia) outer ear. A new ear framework is built either from the child's own rib cartilage, usually from about 8 to 10 years of age, or from a porous polyethylene implant, which can be used from about 4 to 6 years.
- AnaesthesiaGeneral anaesthesia
- DurationAbout 5 to 6 hours (implant); each cartilage stage varies
- Hospital stayUsually a few days per stage
- Back to routineUsually 1 to 2 weeks per stage
What is ear contour correction?
Microtia and anotia are birth differences of the outer ear; the inner ear is usually normal. Microtia means an underdeveloped outer ear, and anotia, the most severe form, means the outer ear is absent and is often associated with a low hairline. The right ear is affected more often, microtia is more common in boys, and about 10% of cases affect both ears. Severe cases often also lack an ear canal (atresia).
The exact cause is not fully known. Suspected factors include reduced blood flow to the developing ear, certain medicines in pregnancy, genetics and a maternal diet low in carbohydrates and folic acid. Microtia often occurs alone but can be part of conditions such as hemifacial microsomia, Goldenhar syndrome or Treacher Collins syndrome.
Two main techniques are used. Reconstruction with the child's own rib cartilage is considered the gold standard. A porous high-density polyethylene implant avoids rib harvest and can be done at a younger age, but carries a risk of implant infection or exposure.
Who is ear contour correction for?
- Children with microtia or anotia
- Rib cartilage technique: usually children aged about 8 to 10 years, when enough cartilage is available
- Porous implant technique: can be considered from about 4 to 6 years of age
- Eligibility depends on the severity of the ear difference and the child's age
How is it done?
- Blood tests and an anaesthesia fitness check beforehand
- Rib cartilage method: 2 to 3 stages over about 6 to 9 months under general anaesthesia
- Stage 1: a carved rib cartilage framework is placed under the skin and the misplaced earlobe rotated into position
- Stage 2: the buried framework is lifted and a skin graft added so the ear stands out naturally; a final stage refines the earlobe
- Implant method: a single operation of about 5 to 6 hours; the implant is covered with a temporoparietal fascial flap and a skin graft, usually from the scalp or abdomen
What is recovery like?
- The child moves to a ward once the anaesthesia wears off
- A normal diet is fine, but do not overfeed or force eating, as nausea is possible
- Children may be less energetic and less hungry for the first 3 days
- Pain and swelling usually settle within a few days with medication
- Regular dressing visits continue until the wound has healed
What are the risks?
- Pain and swelling around the ear and, with the cartilage method, at the chest donor site
- Infection or wound healing problems
- Implant infection or exposure with the polyethylene method
- Skin graft or framework problems that may need further surgery
- Visible scarring and differences in shape compared with the other ear
Why choose Dr. Jithendran?
- Dual training in orthopaedics (MS) and plastic surgery (MCh, DNB), with hand and microsurgery experience from Ganga Hospital, Coimbatore
- Consults at five hospitals across Bengaluru, with 24×7 availability for emergencies
- Clear explanations in English, Tamil, Hindi and Telugu, and time to answer every question
- Strict sterilisation and patient-privacy standards
Frequently asked questions
What is the difference between microtia and anotia?
Microtia means the outer ear is small or not fully formed. Anotia means the outer ear is completely absent and is the most severe form. In both, the inner ear is usually normal, although the ear canal may be missing in severe cases.
At what age can ear reconstruction be done?
Reconstruction with the child's own rib cartilage is usually done from about 8 to 10 years, when enough cartilage has developed. A porous polyethylene implant can be used earlier, from about 4 to 6 years. Your surgeon will advise based on the child's growth and the severity of the condition.
Rib cartilage or implant: which is better?
Rib cartilage is considered the gold standard because it uses the child's own tissue, but it needs a chest incision and several stages. A porous implant avoids rib harvest and needs a single operation, but carries a risk of implant infection or exposure. The choice depends on age, anatomy and family preference.
How many operations are needed?
The rib cartilage technique usually needs 2 to 3 stages over about 6 to 9 months. The porous implant technique is usually done in a single operation lasting about 5 to 6 hours, sometimes with minor refinements later.
How should I prepare my child for surgery?
Blood tests and an anaesthesia check are needed. No solid food for 8 hours before surgery; clear fluids such as water or apple juice are usually allowed up to 2 hours before arrival. Give a bath the night before, and give prescribed medicines with only a small sip of water.
