Ear reconstruction is plastic surgery that builds a natural-looking ear for people born with an underdeveloped ear (microtia) or who have lost part or all of an ear through injury, disease or cancer surgery. It usually uses the patient's own rib cartilage or a Medpor implant and is often done in stages.
- AnaesthesiaGeneral (local is possible for otoplasty)
- Hospital stayDay care for otoplasty; usually 1 to 3 days for cartilage reconstruction
- StagesUsually 2 to 4 operations for rib cartilage microtia repair
What is ear reconstruction?
Ear reconstruction creates a new ear that resembles a normal ear. It is one of the more demanding procedures in plastic surgery and is used for ears that were underdeveloped at birth or lost through trauma, disease or accidents.
The main types are otoplasty (reshaping, repositioning or correcting misshapen or injured ears), microtia repair for congenitally malformed ears, and repair of ear defects caused by trauma or cancer surgery. The choice depends on the underlying problem, the condition of the local skin, and the preferences of the patient and surgeon.
For microtia, the new ear is usually built from the patient's own rib cartilage, typically in children aged about 10 to 16, over two to four operations. Alternatively, a biocompatible porous polyethylene (Medpor) framework can be used and covered with the patient's own tissue so that it integrates with the surrounding skin and blood vessels.
Who is ear reconstruction for?
- Children and adults born with an underdeveloped ear (microtia)
- People who have lost all or part of an ear through injury, bites, burns or accidents
- Patients with ear defects after skin cancer surgery
- People with prominent or misshapen ears suited to otoplasty
- Previous scarring or a low hairline may make reconstruction more difficult; a specialist assessment is advised
How is it done?
- Otoplasty: an incision behind the ear, removal of skin or cartilage if needed, and reshaping or pinning of cartilage with sutures, under local or general anaesthesia
- Rib cartilage reconstruction: cartilage from several ribs is carved to match the healthy ear and placed in a skin pocket, usually over 2 to 4 stages
- Medpor reconstruction: a polyethylene framework is placed and covered with the patient's own vascularised tissue and skin graft
- Ear defect repair: local flaps, grafts or cartilage framework depending on the size of the defect
What is recovery like?
- Soft dressings stay on for a few days, with mild discomfort
- Swelling usually settles over days to a few weeks
- A headband is often recommended for about two weeks, and pressure on the ear while sleeping should be avoided
- Swimming and contact sports are usually avoided for several weeks and direct sun for several months
- Front-buttoning clothes help avoid pulling garments over the head
What are the risks?
- Infection, which needs prompt treatment
- Exposure of the cartilage or implant framework
- Scarring behind the ear, usually hidden in the natural crease
- Chest wall discomfort or scarring at the rib donor site
- Shape or position that differs from the other ear, sometimes needing revision
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 microtia?
Microtia is a congenital condition in which the outer ear is small or not fully formed. It can range from a slightly smaller ear to an almost absent ear and may be accompanied by a narrowed or absent ear canal. Reconstruction aims to create an ear that matches the other side as closely as possible.
At what age is microtia reconstruction done?
When the patient's own rib cartilage is used, reconstruction is usually done between about 10 and 16 years of age, when there is enough cartilage to carve a framework. It is typically completed over two to four operations. Implant-based methods such as Medpor may allow different timing.
Rib cartilage or Medpor implant: which is better?
Both have advantages. Rib cartilage is the patient's own living tissue but requires a chest donor site and several stages. A Medpor framework avoids rib harvesting and can give a refined shape, but carries a risk of implant exposure. Your surgeon will advise based on your anatomy and the local skin.
How should I prepare for ear reconstruction?
Avoid aspirin and certain herbal supplements that can affect bleeding, follow fasting instructions before anaesthesia, shower and wash your hair the night before, and arrange for someone to drive you home and stay with you for a few days.
When should I contact the surgeon after ear surgery?
Seek care promptly for chest pain, exposed cartilage or implant, or signs of infection such as increasing redness, swelling, warmth or discharge. Some mild swelling and discomfort is expected in the first days, but anything worsening should be checked.
