Advanced Care for Management of Microtia Using a Two-Stage Autologous Costal Cartilage Technique for Auricular Reconstruction: Surgical Method, Outcomes, and Future Directions

Auricular reconstruction for microtia remains one of the most technically demanding procedures in craniofacial surgery. The authors present a refined, two-stage approach using autologous costal cartilage. This method, building on the work of Tanzer, Brent, Nagata, and Firmin, demonstrates high aesthetic fidelity and improved patient quality of life. The authors' technique incorporates innovations in framework symmetry, postoperative care, a standardised splinting protocol following the second stage of ear reconstruction, and outcome evaluation using validated health-related quality of life (HRQoL) metrics. This paper outlines the authors' surgical method, reviews published outcomes, and discusses the evolving future of ear reconstruction, including the potential of stem/progenitor cells (such as adipose-derived stem cells) and tissue engineering.