Recently, I have seen some patients in their 20’s with congenital microtia, and when asked why they came to the hospital, the answer was almost unanimous: because their local doctor said they had to be 18 years old or older. Microtia is a relatively common congenital malformation, and the only treatment available is external ear reconstruction surgery. The current conventional method is to use the patient’s own rib cartilage as a scaffold for the reconstructed ear. However, after the child reaches the age of 14, the rib cartilage begins to ossify and its flexibility and toughness begin to diminish, making it less conducive to cartilage sculpting and shaping. What is the best time for microtia repair? The results of an epidemiological survey on the shape and size of the outer ear of adults and children in the northern part of China showed that the size of the outer ear of children at the age of 6-8 years is close to the size of the normal adult outer ear. After years of clinical practice, it has been confirmed that the quality of rib cartilage in children at the age of 6-8 is fully capable of meeting the needs of clinical ear reconstruction, and that outer ear reconstruction surgery should be completed as early as possible for the sake of maintaining children’s psychological health. Therefore, we believe that it is the best time for children to undergo external ear reconstruction surgery at the age of 6-8 years. If a child is growing rapidly, for example, at the age of 4 or 5 years, the height and size of the skull are already close to those of 6 or 7 years old, the surgery can be completed before school age.