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What is Microtia?

Microtia (meaning little ear) is when the outer ear is not as developed. r Microtia can vary from very mild changes in the outer ear shape (Grade 1) to completely missing the outer ear (Grade 4).

Microtia can occur by itself or as part of a larger health picture.  It is often accompanied by hearing concerns.

What is Microtia Reconstruction?

Microtia reconstruction is a series or procedures to create a full size, typical appearing external ear. There are multiple options for microtia reconstruction. The most commonly used one at Children’s Minnesota is to build a natural ear from the patients own cartilage (Cartilage based Microtia Reconstruction).

How is Cartilage Based Microtia reconstruction done?

  • Cartilage Based Microtia reconstruction is usually done in two procedures separated by at least 4 months.
  • In some cases, reconstruction may be finished in a single stage.
  • The first stage involves getting cartilage from the rib cage through a small incision (cut). This cartilage is then shaped into a new ear based on a template from the child’s other ear (where microtia is in one ear) or a standard template (where microtia is in both ears).  The new ear is then put in place under your child’s own skin.  At the end of this procedure your child will have a full size and fully detailed ear, but it will sit flat against the side of the head while healing.
  • The second procedure will lift up the ear, creating space behind the ear and allowing it to extend? away from the head the same amount as the other side. The backside of the ear will be covered by a small skin graft.  The skin graft site will be closed with dissolvable sutures and will not leave a obvious mark once healed.

Are there any instructions I need to follow before surgery?

Your child should NOT take Motrin® (ibuprofen) or other medicines that can increase bleeding risk for at least 3 days before surgery.

Your child must have a physical examination by their pediatrician or family doctor within 30 days before surgery. The doctor you see needs to complete the History and Physical form provided by our office. Bring the completed form with you the day of surgery.

It is very important your child has an empty stomach when anesthesia is given. Follow Children’s Hospitals’ Eating and Drinking Guidelines. If you do not follow these guidelines, your child's surgery will be canceled.

What can I expect after surgery?

Stage 1:

After Stage 1 reconstruction (first surgery) your child will be in the hospital at least two nights.  Small suction drains will be in placed to help the skin mold to details of the new ear.  These drains will be left in place for 3-4 days and can be cared for at home if desired.  Your child may have pain at the rib or ear site, but this can be well controlled with oral pain medication. Protective ear dressing should be worn all waking hours for two weeks and then at night for 4 more weeks. Stiches will be removed at 10-14 days after surgery and can be done with mild sedation if desired.

Stage 2:

Stage 2 reconstruction is an outpatient procedure.  Pain is well controlled with oral medications. Ear dressing should be worn during all waking hours for 2 weeks and at night for 4 more weeks.  Dressings are removed at 10-14 days and may be done with or without sedation.

Pain Control

Ear pain or rib pain is normal for 3-5 days after surgery. Give your child Tylenol® (acetaminophen) or Motrin® (ibuprofen).  Prescription pain medication will be prescribed as needed.

Wound Care

  • Keep ear dressing on continuously for three days, after this it may be removed daily for bathing, cleaning and dressing but should otherwise be on for all waking hours until follow up.
  • After two weeks, daytime dressing can be discontinued, should be worn over the ears at night for 4 additional weeks.
  • Follow-up with your child’s surgeon in 10-14 days after surgery for suture removal
  • Keep bandages dry. Bathing is OK but do not get the ears or dressing wet.


  • Your child should not do any strenuous exercise or activity for 2 weeks. Walking is okay. Do not run, play sports, or lift weights. Do not participate in any competitive sports for 6 weeks.

When should I call my doctor?

  • Ear pain, chest or skin graft site pain that is worsening despite medication
  • Fevers up to 102.0 F are considered normal after surgery. Call your provider for fevers over 102.0 F that do not come down with acetaminophen (Tylenol) and/or Ibuprofen
  • If your child accidentally injures the ear and there is a big change in appearance.
  • Sudden, worsening shortness of breath
  • Dark purple color change of the skin over the newly formed ear.
  • Rapid swelling of the new ear


The information provided in this brochure is not specific to your child. This information is provided as a service to our patients. The information is for educational and informational purposes only and should NOT be used as a substitute for the advice of your child’s physician.

If you have any questions, please call Children’s ENT and Facial Plastic Surgery Clinic.

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This page is not specific to your child, but provides general information on the topic above. If you have any questions, please call your clinic. For more reading material about this and other health topics, please call or visit Children's Minnesota Family Resource Center library, or visit

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