The prevalence of congenital microtia is high, 1:3439 in China, and the large number of congenital microtia in our population affects their image and quality of life in society. As the smallest organ of the body with the most complex three-dimensional structure, the ear not only reflects the three-dimensional changes of the ear on both sides of the skull, such as front and back, left and right, and up and down, but also reflects the complex, multi-layered and individualized micro-anatomical characteristics of the auricle itself, which should make the 10 anatomical structures including the outer ear wheel, ear wheel foot, opposite ear wheel, opposite ear wheel upper foot, opposite ear wheel lower foot, earlobe, ear screen, opposite ear screen, auricular cavity, ear canal, triangular fossa, etc. This is the most challenging work in plastic surgery organ reconstruction. The advantages of applying autologous rib cartilage for staged total auricular reconstruction are personalized sculpting of the reconstructed ear, realistic appearance; good tissue compatibility and ability to withstand certain pressure; staged surgery, less trauma, and no interference with normal school life. METHODS: Autologous rib cartilage was used as the ear scaffold, and total ear reconstruction was performed in two stages, with the first stage of surgery being the contour reconstruction of the external ear anatomy; and the second stage being the cranial ear angle reconstruction. In all cases, general anesthesia with tracheal intubation was used, and the surgery was performed in two stages. The first stage was to reconstruct the anatomical contour of the external ear, including rib cartilage excision and ear stent sculpting and fixation, flap excision and ear stent embedding in the mastoid area, and transposition and articulation of the ectopic earlobe during the same period; the second stage was to reconstruct the cranial ear angle, including lifting of the external ear contour, filling with supporting cartilage or materials, fascial or superficial temporal fascial covering in the mastoid area, occipital The second stage includes lifting of the outer ear contour, filling with supporting cartilage or material, fascial or superficial temporal fascial covering of the mastoid area, advancement of the occipital flap and skin grafting; the second stage includes fixation of the ear stent. The interval between the two procedures is 3 to 6 months. Most patients with small ears have a normal ear on one side, plus the affected ear itself has partial hearing with a hearing threshold of 40-60dB (0-20dB for normal people), so there is basically no effect in normal study and life, and external otoplasty is not considered; for patients with small ears bilaterally, it depends on the specific situation, and if external reconstruction of the ear canal is needed, it should be performed after auricular reconstruction to avoid scar formation after external reconstruction of the ear canal. The formation of scar after external ear canal reconstruction may affect the auricular reconstruction. However, some otologists suggest that the external auditory canal be positioned at the same time as the auricular reconstruction according to the ear CT film, so that the external auditory canal can be reconstructed later. Under normal circumstances, the size of the auricle completes 85% to 90% of its development around the age of 6 years, and the increase in the size of the auricle with age is small; Tanzer and Brent both found that the size of the reconstructed ear cartilage can increase with the development of the child, and its specific mechanism is not clear. Therefore, there is no need to sculpt the auricular scaffold appropriately larger than the healthy ear. It is advocated that rib cartilage from children around 6 years of age can be sculpted into an ear scaffold of adequate size, provided it is properly designed. Ear reconstruction is a delicate procedure with many influencing factors. Adequate skin coverage, delicate ear scaffolds, shaping of fine structures, and postoperative management all affect the final outcome of the procedure. In the author’s opinion, Brent’s method is currently a more ideal and safe method for total ear reconstruction. Its advantages include realistic shape of the reconstructed ear, good histocompatibility and few complications, so it can be applied to patients with congenital small ear deformity or no ear deformity, as long as the skin in the mastoid area is intact, has a certain degree of elasticity and has not been traumatized or left with scarring.