Congenital microtia is caused by the abnormal development of the first and second gill arches, and is an underdeveloped and smaller than normal auricle, often accompanied by atresia of the external auditory canal and malformation of the middle ear. The incidence of microtia is about 1:7000, which seriously affects the physical and mental health of children. At present, a widely recognized surgical method in clinical practice is: skin expansion method combined with autologous rib cartilage grafting method for staged auricular reconstruction, which can obtain good results. Nanjing Children’s Hospital applies the Zhuang’s surgical method of the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences, which is performed in three stages. In the first stage, expander implantation is performed to expand the skin. In the first stage, the expander is implanted under the skin of the mastoid area in a relatively shallow location, in the hairless area behind the ear. The skin flap and subcutaneous tissue fascial flap were slowly expanded with regular water injections. The dilator is a 50 ml kidney-shaped dilator with about 60-80 ml of water injection. It is used in preparation for the second-stage surgery, which aims to provide a thin, sufficiently large, blood-guaranteed flap for ear reconstruction. The treatment process takes about 2-3 months, with regular post-operative water injections, usually two months full, and another month or two waiting for the skin behind the ear to expand sufficiently before surgery. Now, with the added emphasis on skin nurturing, patients are trained to go back and inject their own water, saving money and increasing the “skin nurturing time”, making the flap more likely to survive. In the second stage of surgery, the outer ear is reconstructed by cutting the rib cartilage, sculpting the stent, wrapping the stent with fascial and postauricular implants, and transposing the earlobe. The skin expander is removed and the child’s own 7, 8, and 9 rib cartilage is taken and sculpted into a bony scaffold. The sculpted ear scaffold from the rib cartilage is implanted between the two flaps, below which the residual earlobe is attached, and the superficial temporal fascia is wrapped around the ear scaffold and covered with skin. This results in a reconstructed ear with essentially the same shape as the normal ear, and the reconstructed ear is upright. The second-stage surgery is the key surgery, which is more demanding, with more surgical items to be considered, morphology and blood flow, and the surgery is relatively more complicated. Six months after surgery, the third stage surgery is performed depending on the situation, mainly for local adjustment of the auricle. The three-stage surgery includes ear screen reconstruction, external auditory canal shaping and local trimming of the reconstructed ear, which is commonly referred to as “renovation” to make the reconstructed ear more natural. The Department of Otolaryngology of Nanjing Children’s Hospital and the Otoplasty and Reconstruction Center of the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences have cooperated to perform Zhuang’s three-stage expander method for small ear deformities, which results in realistic auricle shape, appropriate size, consistent color and good results.