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.