​The patient is a 14-year-old boy who was born with a deformed right external ear. There was just a rudimentary structure in place. He had faced significant bullying in school. One of his greatest wishes in life was to be able to wear sunglasses like his father. His parents’ widespread enquiries for the best surgeon to address this issue led them to our hospital.

​Dr SM Balaji, microtia ear deformity surgeon, examined the patient and obtained detailed measurements of his normal left ear. He explained to the parents that the surgery needed to be performed in two stages. It was further explained that cartilaginous grafts needed to be harvested for the procedure. The parents consented to the procedure

​Under general anesthesia, a costochondral graft with an intact synchondrosis was first harvested from the patient. This was in the form of an ‘E’ in order to recreate the cartilage of the external ear. Using a template created from the measurements obtained from the normal ear, the graft was carved to recreate the external ear form.
Attention was next turned to placement of the costochondral graft at the site of the deformed right ear. A subcutaneous pocket was created followed by insertion of the graft into the pocket. The incision was closed and a period of three months was allowed to elapse before the second stage.

​A full thickness skin graft was harvested from the patient’s inguinal (groin) region. This was followed by incising around the cartilaginous graft and raising up the entire superstructure of the recreated right ear. The skin graft was then sutured to cover the exposed tissue behind the recreated pinna. A period of one month was allowed for full healing of the surgical site.

​The patient and his parents were very happy with the results of the surgery. He was now able to realize his long-cherished dream of wearing sunglasses like his father. His earlobe had also been perfectly recreated. They expressed their profuse gratitude to the surgical team before final discharge from the hospital.

A 24-year old female from Mumbai born with a deformed right ear, sought the expertise of Maxillofacial Surgeon Dr. S.M. Balaji for reconstruction of her ear defect. Previously, in some other hospital elsewhere, multiple attempts to reconstruct the ear were done but she was not satisfied with the results. Hearing was normal.
Dr. Balaji employed the Limberg’s flap to successfully reconstruct the ear lobule. Followed which stage wise complete ear lobe reconstruction done using costochondral rib graft. Costal cartilage was harvested; external framework was carved and tunneled to reconstruct the external ear.
 After suction, the skin was seen getting adhered to the cartilage.  This was followed by the second-stage surgery to elevate the newly formed ear from the side of the head using split skin graft obtained from right thigh region. Thus, entire shape and size of the ear was reconstructed with enhanced appearance without much visible scars.

25 year old man reported to our hospital seeking for cosmetic correction of his right ear defect. He consulted many plastic surgeons for the surgical correction but was not satisfied.
On examination, the helix of the right ear was defective. Maxillofacial Surgeon Dr. S. M. Balaji successfully corrected his ear defect using wedge closure technique without much visible scars. Results are immediate. He is very happy to have single stage ear defect correction. 

Microtia is a congenital malformation of variable severity of the external and middle ear. This condition is corrected by staged ear reconstruction using autogenous costal cartilage.
Shown here is a case of pediatric external ear reconstruction. The girl’s left microtic auricle had remnants of disorganized cartilage with an earlobe. This surgery is normally performed at about 14-15 years of age but it was done at a younger age in this 10-year-old because she was facing psychological problems as a result of being teased a lot for her ear defect by other children at school.
A template of the normal side was designed to recreate the key elements of the ear shape on the affected side. Costal cartilage was harvested; external framework was carved and tunneled to reconstruct the external ear. After suction, the skin is seen getting adhered to the cartilage.  This will be followed by the second-stage surgery to elevate the newly formed ear from the side of the head.
Ear reconstruction surgeries are a demanding undertaking and must be performed with skill, precision & artistry.

An 18 year old boy was brought to our hospital by his parents for complete reconstruction of his ear defect. He had a large button-holing defect in the helix of his left ear due to which he was teased a lot and it affected his self-confidence.

Maxillofacial Surgeon Dr. S.M. Balaji skillfully performed the surgical ear reconstruction in 2 stages. In the first stage the specialized island flap was raised just behind the ear and the edges of the button holing defect in the pinna of the ear was cut. The defective pinna of the ear was sutured with the island flap behind the ear. In the second stage after 6 months, the pinna of the ear was separated from the flap behind the ear and the detached region was sutured. The size of the defect was measured using lint and the required size of skin graft was harvested to close the raw plane of the ventral surface of the ear and it was sutured by means of quilting technique to avoid spacing between the skin graft and recipient site and seroma formation. Thus total reconstruction was done without much surgical scars. Results are immediate and we will update this case by post operative photos with complete healing later.