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.

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.

Dr. Mobley wants to make cosmetic surgery available to as many people as possible. For that reason we have hand picked lending services exclusively for Dr. Mobley's patients. When you come in for your consultation we will be more than happy to go over all your financial options with you. We have provided web links to our financial lenders so that you may research them on your own if you so desire.www.mlendfinancial.com

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.

Microtia repair is reconstructive surgery and, as always, we place a very strong emphasis on your (or your child’s) medical safety. The first surgery that involves use of the rib cartilage to reconstruct the ear is always performed on an inpatient basis at the University Hospital. Most all patients will stay over one night. Some of Dr. Mobley’s younger patients may spend an additional night in the hospital. The other stages of microtia repair can be performed either in the hospital setting or an outpatient surgical center. In every surgery, you will be put to sleep and monitored by an M.D. anesthesiologist, and I will personally perform the operation.

Yes. I work with one of the top prosthetic specialists in the Intermountain West who is also on staff at the renowned Huntsman Cancer Institute. In specific medical situations, a prosthetic ear may be a better choice for certain patients. For younger patients, I feel that it is best to try to build an ear out of their own body parts using the rib cartilage technique described above. However, for older patients or younger patients with certain conditions, a prosthetic ear is sometimes an alternative way to go. During your consultation, we will discuss this option and determine if it’s right for you.

Reconstruction of a congenitally malformed ear is one of the most challenging surgeries Dr. Mobley performs. Since patients present with degrees of malformation, it requires great surgical experience and an artistic eye to determine what techniques will be necessary to employ in the reconstruction.

A newspaper article was written about Dr. Mobley and one of his microtia patients:

Surgical procedure boosts hearing, self confidence. Salt Lake Tribune, November 3, 2004.