PMC

a Photograph showing grade I microtia. b Photograph showing grade II microtia. c Photograph showing grade III microtia

a Preoperative photograph of lobule-type microtia. b Three-dimensional costal cartilage framework. c Patient after the first stage with insertion of framework under the skin pocket. d Patient after the second stage with ear elevation and lobule-transposition

a Preoperative photograph of lobule-type microtia. b Three-dimensional costal cartilage framework. c Patient after the first stage with insertion of framework under the skin pocket. d Patient after the second stage with ear elevation and lobule-transposition

a Donor site: chest on side opposite to ear being repaired. The helical rim is obtained from “floating” rib cartilage, the main pattern from a fused block of two cartilages. b Sculpting the main block with chisel. c Thinning the “floating” rib cartilage to produce the helical rim. d Affixing the rim to the main framework with nylon sutures. e Completed framework []

Preoperative determination of auricular location. The ear’s slant is positioned to match the opposite side, roughly parallel to the profile of the nose; the distance is matched from the corner of the eye and the microtic lobe’s position is noted (usually displaced upward) when tracing the reverse film pattern, so that the lobe will eventually be positioned correctly when it is transposed into position and “spliced” into the new ear during the second stage of the surgical repair