A Single-Stage Silicone Implant With Temporal Fascia Flap For Adult Microtia Reconstruction: A Case Series

Introduction: Microtia reconstruction in adults presents unique challenges distinct from paediatric populations. While autologous costochondral grafting is the gold standard, it is a multi-stage procedure with significant morbidity. Alloplastic frameworks offer a single-stage alternative but carry risks of extrusion, particularly without robust coverage. This case series evaluates the outcomes of a single-stage technique using a silicone implant covered by a temporal fascia flap (TFF) for adult microtia reconstruction. Methods: A retrospective review was conducted on 12 consecutive adult patients (age range: 19-42 years) with unilateral congenital microtia (Grades III-IV) who underwent reconstruction with a custom-carved silicone implant and a pedicled TFF between august 2023 and June 2025 in SVIMS. A thin skin graft was applied over the flap. Primary outcomes included aesthetic result (evaluated by a blinded surgeon panel using a 10-point scale) and complication rates. Secondary outcomes included patient satisfaction. Results: The mean follow-up period was 18 months (range: 12-30). The mean aesthetic score was 8.2/10. No cases of major implant extrusion occurred. Minor complications included partial graft loss in one patient (8.3%) and temporary temporal hollowing in two patients (16.7%), which resolved with conservative management. All patients reported high satisfaction with the aesthetic outcome and the single-stage nature of the procedure. Conclusion: Single-stage auricular reconstruction with a silicone implant and TFF is a viable and effective option for adult patients with microtia. It provides satisfactory aesthetic results with an acceptable complication profile, avoiding the donor-site morbidity and multiple surgeries associated with autologous techniques. This approach is particularly suited for adults seeking a definitive correction in a single intervention.