Congenital microtia refers to severe auricular hypoplasia, which is often accompanied by atresia of the external auditory canal, middle ear malformation and frontal facial deformity, with an incidence rate of 1:7000, more common in males, and the malformation on the right side of the person accounts for more than 90%. Clinically, microtia is divided into three degrees: Ⅰ degree of the auricle is still recognizable in all parts of the auricle, only the auricle is smaller; Ⅱ degree of the auricle structure is not recognizable, the residual ear is irregular, in the shape of a peanut or weenie, atresia of the external auditory canal; Ⅲ degree of the residual ear is only a small dermatomal flap or a small mound, or only a translocated earlobe. The complete lack of development of the auricle and the absence of any local traces is called auria, which is extremely rare. External ear reconstruction surgery is the current plastic surgery treatment for microtia. Auricular deformity will seriously affect the normal psychological development of children, preschool children face school reading, begin to understand, know that they have defects or have a sense of inferiority, there is a demand to change their own defects of the desire, this period of time for the outer ear reconstructive surgery, is conducive to the normal psychological development of children; at the same time, the development of children’s ear at this age is close to the size of the adult ear contour, the rib cartilage can meet the need for reconstructive ear bracket. Therefore, in order not to affect their psychological development, reconstructive ear surgery should be completed before school age. The surgical design of external ear reconstruction has to consider three aspects, namely, the external ear scaffold, the covering skin and the treatment of residual ear tissue. The choice of scaffolding is currently preferred to autologous rib cartilage, the application of autologous rib cartilage sculpture of the outer ear scaffolding is the patient’s own tissue, easy to survive, stable and reliable, not easy to be absorbed and fibrosis, not easy to be infected after the operation, tough and easy to sculpture, etc.; covering the source of the skin behind the ear is the most desirable part of the skin, but the amount of skin is often insufficient, and often need to be used after the skin behind the ear after the expansion of the skin; the majority of the patients with microtia have a remaining earlobe, which should be fully utilized. Most patients with microtia have residual earlobes, which should be fully utilized and not easily removed. The outer ear reconstruction surgery is carried out in two stages, the first stage of the surgery is to deal with the residual ear, buried behind the ear expander. The application of expander technology effectively solves the problem of insufficient amount of skin behind the ear when reconstructing the auricle in the second stage of surgery. After the expander is embedded, it is injected with water over a period of 1-2 months, so that there is sufficient amount of skin in the second stage of surgery. The second stage of surgery is to apply the patient’s rib cartilage, sculpt the auricular scaffolding, remove the postauricular expander, and bury the auricular scaffolding under the expanded skin flap to complete the outer ear reconstruction. After the ear reconstruction is completed, there are 1-2 more surgical revisions to make the outer ear more lifelike. External ear reconstruction is a more complex surgery in plastic surgery, currently can only make the shape of the auricle and the normal ear roughly similar, but can not make its subtle structure and cartilage elasticity and the normal ear exactly the same, therefore, the patient should understand the difficulties of the operation, the operation should be realistic attitude, believe that in the near future, human beings can be complete reconstruction of the organ, also can be complete reconstruction of the ear to fake real. The patient should understand the difficulty of the surgery and be realistic.