Age of Microtia Repair

At what age can microtia be repaired?

At around eight to ten years of age, the cartilage in a child’s ribs is robust and thick enough to produce a framework for reconstruction.  It is also easier to actually harvest the cartilage graft in a larger child while avoiding a deformity of the chest wall.  There is also a strong psychological reason for waiting. Post-operative care can be very difficult on the child and all those involved in their care.  It is important for the child to be old enough to understand and personally “consent” to having the surgery. Even though some surgeons have started surgery in children as young as 5 or 6 years of age, we rarely encounter children requesting surgery at these ages but we frequently encounter parents requesting surgery on their children well before this.  Having some patience, and waiting for the child to be physically larger and psychologically more mature results in a far better permanent outcome.  

The advantages of waiting until a child is older allows for:

• Best symmetry in size with the opposite ear after complete growth.
• Best symmetry in location of the ear in comparison to the opposite ear allowing for growth of the face and jaw.
• Presence of a larger, more robust cartilage graft from the rib.
• A more mature child who can consent and be an active participant in the decision for surgery and in the recovery period.