FREQUENTLY ASKED QUESTIONS
About Microtia Surgery

What Is Microtia?

What Are The Surgical Steps To Correct Microtia?

What Are My Financing Options With Dr. Mobley?

What Kind Of Recovery Is Expected Each Stage?

What Should I Expect The Day Of Surgery?

Do I Have The Option Of Prosthesis vs. Surgery?

In the most straight-forward terms, microtia is an irregular development of the outer ear. Often, instead of a normal ear, all that is present is soft, fleshy tissue similar to earlobe tissue. In less severe forms, the ear looks mostly normal but smaller in size. Microtia is a birth defect that occurs in about 1 in every 6,000 births. Most of the time it affects the right ear; and in one-third of cases it affects the left ear. Both ears are affected in 10% of cases.

Back to top of page

In my opinion, microtia repair is one of the most complex operations performed by facial plastic surgeons. Some surgeons choose to use an artificial implant on which to build a new ear. Since ears are naturally made out of cartilage. I believe in using the individuals own rib cartilage to literally sculpt a new ear. My belief is that by using the individuals own tissues the ear is a real living structure that will stand up to aging, some amounts of trauma, and even infection. The creation of a new ear involves four separate operations, and usually takes a little under one year to achieve the final result.

First stage: This is the stage where cartilage is taken from the rib cage and used to sculpt a new ear. This is best performed when the child is old enough and mature enough to participate in the postsurgical care but before cruel teasing by peers begins. The ideal age varies, but is usually between the ages of 6 and 10. In this surgery an incision is made in the chest and cartilage is removed from the ribcage. I carve the cartilage into the shape of a human ear (click for image). This is placed in a pocket under the skin where a normal ear would be positioned (click for image).

Second stage: This most often involves repositioning of the earlobe. The earlobes of microtia patients are usually too far forward and too high. We release the earlobe surgically, moving it lower and into the correct position.

Third stage: This is the smallest of the four operations. In front of a normal ear canal is a piece of cartilage that bulges away from the head slightly, known as the tragus. Microtic ears almost always lack a tragus. We borrow a piece of cartilage from the back side of the patient’s normal ear to construct a tragus for the microtic ear.

Fourth stage: The new ear, formed from carved cartilage covered with skin, is lifted away from the scalp, and a skin graft is placed on the back side of the ear. The skin graft is usually harvested from the buttocks where it is hidden by normal underwear or a bikini so that the scar is not visible.

Back to top of page

The most difficult recovery is after the first stage. Since it requires the harvesting of rib cartilage, patients are usually most comfortable spending one or two nights in the hospital following the surgery. Small drains will have been placed during surgery in the scalp area. The other three operations are all done on an outpatient basis, and recovery is relatively minimal. After the fourth stage, the skin graft donor site is often tender for a week or so. Medical ointments are prescribed, and this area usually heals quickly.

Back to top of page