Ear reconstruction surgery is considered one of the most challenging plastic surgery procedures. It’s quite rare - the majority of plastic surgeons see 1-2 cases per year – but the results are now excellent due to advances in reconstructive surgery. This type of ear surgery is requested by two main groups of patients: those who have an underdeveloped ear at birth (a condition known as microtia) and those who have lost a normal ear through trauma, disease or accident.
The first stage involves creating a skin pocket at the site of the ear by reshaping the available tissue and thinning the skin to mimic the ear skin. Rib cartilage is then harvested in three pieces. The rib cartilage is carved and wired together with fine stainless steel wire to produce a very detailed ear structure. The structure is then inserted in the pocket and gentle suction is applied to enable the skin and the ear structure to come together. This stage of ear surgery takes 4-6 hours and the expected length of stay in hospital is 5-7 days.
At the second stage the new ear needs to be put into position so it sticks out from the head like a normal ear would. The new ear is lifted into place with a piece of cartilage behind it to support its position. A flap of tissue and a skin graft is then taken to cover exposed cartilage and compete the process. The second stage takes 3-4 hours and the expected hospital stay is 2-3 days. Ear reconstruction surgery has a high success rate with over 90% patients grading the result as good or excellent. However, some patients, such as those with scarring or a low hairline, may be less suitable for ear correction surgery and will need to speak to a specialist.
The alternative to ear reconstruction or correction surgery is a prosthetic ear, which is clipped onto titanium pins inserted into the skull. The disadvantages of a prosthetic ear are that it needs to be removed daily for cleaning, it can be accidentally unclipped, and patients can suffer from pin complications or poor colour match. The advantage is that it is a simpler operation compared with ear reconstruction surgery. For ear birth defects, also known as microtia, ear surgery is usually deferred until the age of nine or above.