Bilateral auricular defects are caused by trauma or infection, and have their own characteristics when compared with tissue defects in congenital microtia, such as localized skin is often scarred, with poorer blood supply, elasticity, and laxity. It is not possible to make a thin subcutaneous wide peeling, it is not easy to form a wide and loose cavity that can accommodate the implanted stent tissue, therefore, it is often difficult to clearly show the shape of the contour carved on the stent. However, even if the defect is severe, there are still some ear nails and external auditory canals left, which makes it easy to achieve a better shape of the reconstructed auricle. For the repair of auricular defects, the basic principles of total auricle reconstruction can be referred to, and combined with the location, size and local tissue condition of the defect, suitable surgical methods and tissue grafts can be selected for repair. Double auricular defects require partial or total reconstruction of the auricle. However, it is worth noting that auricular reconstruction is a difficult and complex surgery. Although it is now possible to make the shape of the reconstructed auricle similar to that of the normal auricle, the softness and elasticity of the reconstructed auricle can not be completely matched with that of the normal auricle due to the fact that normal auricle cartilage belongs to the elastic cartilage, whereas the rib cartilage is a hyaline cartilage, which does not contain elastic fibers. Auricular reconstruction can be performed on patients who request it, understand the difficulties of the surgery, and have a realistic attitude towards the outcome, otherwise, caution should be exercised. Otherwise, auricular reconstruction should be performed with caution. Elderly and frail patients should wear prosthetic ears and should not undergo auricular reconstruction.