Microtia reconstruction is a complex procedure performed by the facial plastic and reconstructive surgeon and requires an expert understanding of the three-dimensional structure of the ear. This article provides an overview of the evolution of microtia reconstruction through history. Techniques pioneered by microtia surgeons Drs. Radford Tanzer, Burt Brent, Satoru Nagata, and Françoise Firmin will be described along with an additional excerpt on the utilization of porous polyethylene (Medpor; Stryker, USA). The objective for the reader is to be able to summarize approaches of each major reconstructive technique, compare the differences in techniques, and gain an understanding of the advantages and disadvantages of each approach.

Since the pioneering use of autologous rib cartilage for the reconstruction of microtia, there have been significant advances in surgical technique that have helped to ameliorate the psychological burden of microtia. To date, the use of rib cartilage for auricular reconstruction is one of the most enduring and ubiquitous techniques for microtia reconstruction as it provides excellent aesthetic results with lasting durability. In this review, the authors outline the most common methods of microtia reconstruction with a comparison of each technique and illustrative case examples.