Ear reconstruction is a very complex procedure with many methods. The ear is made up of skin and cartilage scaffolding, so ear reconstruction begins with consideration of these two factors. The ear scaffold is now generally considered to be the most ideal with autologous rib cartilage; the skin is best with hairless skin in the mastoid area. Depending on how the skin of the mastoid area is used, the procedure can be divided into several methods. The traditional approach is the Tanzer-Brent staging method, which is done in four stages: 1) posterior transverse transfer of the earlobe; 2) excision of the rib cartilage and sculpting to form an ear scaffold to be implanted under the skin of the mastoid area; 3) lifting of the auricle and freeing the wound for skin grafting; 4) reconstruction of the ear screen and the auricular cavity. The whole process takes about half to one year. Our scholars have applied the one-stage method to reconstruct the auricle. The advantage of this method is that it saves time and money and only takes two weeks to complete. The disadvantage is that the skin of the mastoid area is not enough and extends upward with some hairs, so that the reconstructed ear is thicker and has hairs on the edge of the ear whorl, and this method is rarely used now. Currently, the most common method is to apply a skin expander to slowly expand the hairless skin of the mastoid area and then perform the ear reconstruction. This procedure is performed in two stages, as follows: the first is the placement of the dilator, which is a very small procedure and is usually performed under local anesthesia. The stitches are removed after one week and water injection begins, which takes a total of three weeks. The second surgery is then performed after a month of rest and takes about 10 days to reconstruct the ear. The two surgeries take about two months. The current cost for the entire procedure is about 25,000 RMB (subject to fluctuation according to policy). Some patients will be satisfied with the results after this second surgery, but may require later revision of the fine structure of the auricle. For some patients who are going to have ear canal surgery, it can usually be done after six months. Using materials instead of cartilage to form the ear scaffold can eliminate the pain of cutting rib cartilage. Many scholars have been trying to replace the autologous rib cartilage with artificial materials, and the materials that have been used are polyethylene, ivory, nylon mesh, polyester mesh, silicone rubber, PTFE mesh, porous polyethylene, etc. However, the ear scaffold exposure is a problem. In our country, ear reconstruction started late, and it is a welcome phenomenon that many physicians are interested in this surgery that involves almost all the basic skills of plastic surgery and at the same time must have a certain level of artistic sculpting. However, the small amount of autologous rib cartilage in children and its individual shape require long and painstaking training to sculpt it into a three-dimensional ear scaffold. Synthetic ear scaffolds are pre-made in the factory, eliminating the need for sculpting training, and are therefore easily accepted by some physicians, with some even advertising them as “the newest material from the United States”, “synthetic material with high-tech digital technology”, etc. Currently, autologous rib cartilage is still the most trusted ear scaffold, with the fewest postoperative complications. This principle is adhered to by internationally accomplished practitioners in the field of ear reconstruction. After all, artificial material is a foreign body and expulsion is a natural consequence, especially in thin-skinned auricles. Of course, for patients who are too old and frail or who have chest wall disorders that preclude excision of rib cartilage, synthetic materials can be considered for ear scaffolds, but they should be monitored regularly after surgery. Using modern tissue engineering techniques, cultured chondrocytes are grown as seeds on an ear scaffold prefabricated with synthetic material and implanted under the skin on the back of nude mice. The early work was interesting and was covered by various news media in China for several years, and now it is almost a household name and has attracted the attention of all parties, and a lot of funding has been invested. However, this method still has problems that need to be solved and cannot be transitioned to the clinic yet.