The auricle develops from the first two gill arches of the embryo, and the normal auricle develops to more than 85% of its adult size by the age of 4 to 5 years, with extremely slow growth thereafter. After the age of 60, the auricle again increases in size because the tissue loses elasticity, but the inner substructure of the auricle flattens out. Abnormalities during embryonic development can lead to auricular malformation. According to the principles of treatment we usually classify them into three main categories: large ear deformity, external ear deformity and small ear deformity. The large ear deformity requires removal of excess tissue; the external ear deformity only corrects the abnormal shape of the auricular cartilage without adding or removing tissue; and the small ear deformity requires the addition of tissue for rebuilding. 1. Large ear deformity 1. Disease description: Simple developmental large ear deformity is extremely rare. The development of each structure of the ear is normal, but it is larger than the normal ear, and the overall size of the ear is abnormally large in terms of longitudinal, lateral, cranial angle and thickness of the ear. 2. Timing of treatment: Treatment should be carried out after the child is 4 to 5 years old. The main purpose is to correct the affected auricle according to the size of the normal side of the auricle. 3.Surgical method: The auricle area is reduced by removing the tissue in a star shape. Most of the surgery is needed to reduce the thickness of the auricle and the height of the cranial angle of the ear in stages. Then there is the large ear deformity which mostly originates from other diseases, such as hemangioma, nevus, cauliflower ear and so on. These original diseases stimulate the auricle to enlarge abnormally, so the focus of treatment is on the original disease and the correction of the enlarged auricle deformity. External ear deformity 1. Introduction to the disease: The incidence of external ear deformity is very high and is divided into various subtypes according to appearance. There are also some patients who have entirely cosmetic needs and do not really have a deformity of the ear. This type of disease is mainly characterized by malformation and distortion of the auricular cartilage and abnormal morphology of certain sub-structures. However, after the auricle is pulled and folded, the size and shape of the auricle is basically symmetrical to the normal side. These disorders include: wind-up ear, cup-shaped ear, hidden ear, butterfly ear, ape ear, attached ear, shell ear, and ear screen oversized deformity. 2. Timing of treatment: Treatment should be carried out after the child is 4~5 weeks old. The correction of auricular cartilage deformity will leave a scar and may affect the development of the ear, so premature surgery is not recommended. 3.Surgical method: Through the skin incision behind the ear, the deformity of the auricular cartilage is corrected and the substructure within the auricle is reconstructed. There is basically no need to transplant tissue to fill in. The area of the auricle is significantly smaller than the normal ear, especially the upper part of the auricle is not developed at all, and it is often complicated by atresia of the external auditory canal and underdevelopment of the maxillofacial bones. There are also auricular defects caused by trauma. 2. Timing of treatment: At least after 6 years of age, and the height should be more than 1.2 meters. These patients need to have the outer ear reconstructed by transplanting autologous rib cartilage, so cutting up to three rib cartilages will not cause thoracic deformity and will be sufficient to make an ear brace. 3.Surgical methods: There are two methods with the best treatment effect, namely, non-expansion ear reconstruction and expansion method ear reconstruction. The specific method is decided according to the patient’s own conditions and requires the doctor’s experience. (1) Non-expansive ear reconstruction: The first stage of surgery is to cut one to three pieces of rib cartilage from the thorax to make an ear scaffold, which is then buried under the skin of the mastoid area to form an ear shape, but the reconstructed ear is close to the scalp. The treatment procedure takes about 2 weeks. After 4 months, the second stage of surgery is performed, in which the ear is lifted from the mastoid area, supported behind the ear, and implanted with skin. The procedure takes about 2 weeks. The two-stage surgery basically completes the entire treatment, and a minor revision surgery can be done after six months if necessary. (2) Expansion method ear reconstruction: The first stage of surgery is to implant expanders under the skin of the mastoid area and slowly expand the skin. The treatment process takes about 2 to 3 months and is immediately followed by the second stage surgery. The second stage of surgery takes rib cartilage to sculpt the ear scaffold and then uses the expanded skin to cover the ear scaffold. The reconstructed ear is upright. The procedure takes about 2 weeks. The third stage of surgery is performed after 6 months to remove the residual ear tissue and deepen the ear eye. The procedure takes about 2 weeks. This is a rough overview of the classification and treatment of auricular deformities. If treatment is indeed needed, it is still most appropriate to see your doctor in person to learn about the treatment and the cost of surgery. You can also find out the doctor’s level of knowledge about this type of disease and ultimately help you determine your surgeon and options.