Ear reconstruction may be required in the following cases:

• Congenital disorders like atresia (absence of the external ear) or microtia (small ear)
• Injury or trauma to the ear
• Genetic disorders like Treacher Collins syndrome and Goldenhar syndrome
• Misshaped ears, like pointed ears, large ears, or lop ears (when the ear tip folds down)

The following diagnostic tests may be performed before an ear reconstruction procedure:

1. Physical examination: The doctor evaluates the shape, size, and placement of the patient’s ears. The doctor also takes photographs and measurements.
2. Medical history: The patient’s medical history, history of trauma or injury, history of a previous ear infection, and history of any previous surgeries is asked by the doctor.
3. Blood tests and urinalysis: These tests are performed before surgery to check for any underlying infections.
4. X-rays and CT scans: Imaging tests like x-rays and CT scans may be useful to get clear images of the internal structures of the ear.
5. General screening tests: The doctor may perform a whisper test. The patient is asked to cover one ear at a time to evaluate how well the patient can hear the words spoken at different volumes, and also how well the patient can respond to other sounds.
6. Tuning fork tests: This test helps the doctor to check for loss of hearing.
7. Audiometer tests: This is a more thorough type of test performed to check for loss of hearing.

• The procedure is may be done under local anesthesia with sedation (by numbing the area of the procedure) or general anesthesia (the patient is made unconscious during the procedure).
• The surgeon makes an incision inside the folds of the ear or back of the ear.
• The ear tissue is now manipulated depending on the type of procedure being performed. This may include skin or cartilage removal, shaping and folding of the cartilage using permanent sutures (stitches), or grafting of the cartilage to the ear.
• The incisions are then closed using sutures.
• Certain types of ear reconstruction surgeries may not require an incision. The procedure involves the placement of a needle into the cartilage to increase its flexibility. Sutures are then used for fixing or reshaping the ear.
• The procedure normally takes one to three hours to complete.

The complications that could occur as a result of the ear reconstruction procedure are:

• Bleeding
• Infection
• Blood clot formation 
• Allergic reaction to anesthesia, tape, glues, blood products, topical preparations, or injected agents used
• Asymmetry of the ear
• Changes in the sensation of the skin
• Persistent pain
• Poor wound healing 
• Irregularities of the skin contour
• Swelling
• Skin discoloration
• Scarring
• Need for another surgery

• The ears of the patient are covered in bandages to support and protect the ear after the procedure.
• It is normal for the patient to have some redness, soreness, itching, swelling, and discomfort after the procedure.
• The doctor prescribes painkillers to relieve the pain and discomfort of the patient.
• The patient should avoid sleeping sideways till complete healing occurs to avoid pressure on the operated ear.
• The patient should avoid rubbing or placing excessive force on the incisions.
• The patient should wear button-down shirts or shirts having loose-fitting collars to avoid clothes rubbing against the ears.
• The bandages are removed by the doctor a few days after the procedure. The ears are likely to be red and swollen.
• The patient may need to wear a loose headband covering the ears at night for some weeks. This prevents the patient from pulling his/her ears forward when rolling over in bed.
• Dissolvable stitches disappear on their own. However, non-dissolvable stitches need to be removed by the doctor a few weeks after the procedure.
• The patient should follow the doctor’s instructions on when to resume daily activities like bathing and other physical activities.
• Light exercises like walking can be resumed three days after the surgery.
• Heavy lifting and strenuous physical activities can be resumed three weeks after the surgery.
• Swimming should be avoided for four to six weeks after the surgery.
• Sun exposure, sun lamps, and tanning beds should be avoided for six weeks after the procedure.