After adequate healing, in this 2nd stage, the inserted cartilagenous graft was identified. Clear, precise incision to simulate the pinna outline was drawn. Using careful elevation, and use of excess cartilageal blocks, the reconstructed pinna was lifted and positioned. Pericranial tissues have to be left intact and adequate care need to be exercised. This elevated flap was debulked to resemble the normal external pinna. Resorbable sutures were carefully placed to simulate the rolled margins. The defect left behind has to be closed – either by a temporal flap or a similar approach. In the present case, simultaneously, a full thickness graft was raised from the groin region. Excess fat tissues and adnexial structures were carefully removed. The donor site was closed in layers. This full thickness graft was then carefully placed and sutured accordingly in layers.
This step results in a successful creation of 3D soft tissue contour. Later in the 3rd step, the lobule of the pinna will be repositioned to complete the ear reconstruction