Rib Cartilage Ear Reconstruction

Medically reviewed by Youssef H. Tahiri, M.D.

Using a child’s rib cartilage to carve an ear framework has been popular for more than 40 years. Cartilage reconstruction is a technique that requires between two and five surgeries. The surgeries start when the child has grown big enough, typically between six and ten years of age, to provide enough rib cartilage to make an adult size ear.

First, the cartilage from several ribs is removed through an incision on the child’s chest. The cartilage is carved and pieced together to create an ear framework. This framework is buried underneath the scalp. After the ear has healed, more surgeries are required to complete the reconstruction: elevating the ear away from the scalp, repositioning the earlobe and other adjustments.

ADVANTAGES

This technique uses the body’s own tissue exclusively.
In expert hands, the patient may have an excellent, long-lasting result.
Reconstructed ear can withstand the rigors of most sports, not necessarily because it is made of rib, but because it does not project much from the scalp and therefore may be less likely to be subjected to trauma.

DISADVANTAGES

This technique requires between two and five surgeries.
Rib ear reconstruction is done after children have already started school, around 8-10 years old, meaning they will begin their education with noticeable microtia.
Cartilage removal may be painful and requires hospitalization, IV pain medications, a permanent chest scar and potential chest wall deformity.
Canal surgery cannot begin until after the ear is reconstructed with cartilage. As a result, hearing cannot be restored until children are older after significant brain development has taken place.
Cartilage ears do not project from the side of the head often necessitating a procedure to “pin back” the opposite ear for symmetry.