Dra. Angélica Paulos 

Ear reconstruction in the presence of a microtia or anotia is complex. It is a long surgery, not without complications and that requires multiple surgeons. It may require multiple surgeries to achieve all reconstructive goals.

1.- First surgical time: it consists of resecting the cartilaginous remnants of the microtia, lifting a skin flap that will receive the new ear, resecting rib cartilages (from the thorax), carving a cartilage frame in the shape of an ear and placing it on the flap previously dissected. Drains are left to allow the skin to attach to the carved frame and to define the nooks and crannies of the carved frame and to prevent blood pooling. A special system of local analgesia is left in the chest. The patient remains hospitalized for as long as he needs according to the evolution of the pain, fluid leakage through the drains and his general condition.

2.- Second surgical time: this is performed at least 6 months after the first one. It consists of the realization of the retroauricular groove, using local grafts and flaps. It requires frequent post-operative cures, since it tends to moisten the area.

3.- Third surgical time: In some occasions other procedures may be needed, such as laser hair removal or pinching of some poorly defined areas of the neo-ear.