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Wang et al. Plast Aesthet Res 2016;3:364-7 Plastic and
DOI: 10.20517/2347-9264.2016.79
Aesthetic Research

www.parjournal.net
Original Article Open Access

Full retroauricular skin and fascia expansion

in microtia reconstruction: a single center

experience of 166 cases

Ji-Hua Wang, Ting Tang, Yong-Jing He, Ying-Jia Zhang, Yun Yang

Department of Plastic Surgery, the Second Affiliated Hospital of Kunming Medical University, Kunming 650101, Yunnan, China.
Correspondence to: Prof. Ji-Hua Wang, Department of Plastic Surgery, the Second Affiliated Hospital of Kunming Medical University, Dianmian
Great Road, Kunming 650101, Yunnan, China. E-mail: wangjihua1966@163.com
How to cite this article: Wang JH, Tang T, He YJ, Zhang YJ, Yang Y. Full retroauricular skin and fascia expansion in microtia reconstruction: a
single center experience of 166 cases. Plast Aesthet Res 2016;3:364-7.
ABSTRACT

Article history: Aim: Ear reconstruction is a challenge for plastic and reconstructive surgeons. The ear requires
Received: 21-09-2016 sufficient skin coverage and a three-dimensional (3D) cartilage framework. In this paper, the
Accepted: 04-11-2016 authors present their 10-year experience in microtia reconstruction using tissue expansion
Published: 30-11-2016 and an autogenous rib cartilage framework. Methods: Ear reconstruction was performed in 3
operative stages. During the first procedure, a 50-80 mL kidney or cylinder-shaped expander was
Key words: implanted deep to the subcutaneous fascia of the retroauricular mastoid region. Over a period of
Microtia, 3-5 months, the expander was filled to a final volume of 80-110 mL. In the next operation, the
expansion, retroauricular fascia was eliminated or reserved following expander removal, and the autogenous
autogenous costal cartilage, costal cartilage framework was placed below the expanded skin flap. At the third and final stage,
ear reconstruction the earlobe transposition, tragus construction and conchal deepening were performed. Results:
A total of 165 patients (166 ears) were reconstructed using tissue expansion and an autogenous
rib cartilage framework. Complications included hematomas in 3 cases, expander exposure in
8 cases, cartilage exposure in 6 cases, infection and cartilage resorption in 2 cases, exposure
of steel wire in 4 cases, and aseptic seroma in 2 cases. Follow-up ranging from 3 months to 5
years showed that 159 patients were satisfied with the reconstructed ear including size, location,
projection, convolution, skin-colour matching, symmetry with opposite ear. Conclusion:
Expansion of the retroauricular skin and fascia can provide sufficient non-hair-bearing skin and
tissue for coverage of a three-dimensional costal cartilage framework. Avoidance and prompt
treatment of complications are advised in order to obtain a satisfactory reconstruction of the ear.

INTRODUCTION skills, successful ear reconstruction is dependent upon
a framework for the ear material and the overlying
Ear reconstruction with autogenous rib cartilage for skin coverage. Autogenous costal cartilage has been
congenital microtia is a challenge for plastic and widely used as a source of the ear framework. [1-4]
reconstructive surgeons. In addition to the surgeon’s However, great success was not achieved until 2006

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