Congenital microtia, also known as “congenital malformation of the external middle ear”, is a unilateral or bilateral auricular deformity at birth. In mild cases, the auricular structure is small and vague; in severe cases, only a peanut-shaped residual ear remains in the outer ear, or even the entire outer ear auricle is missing. In some cases, there is facial asymmetry, which is also known as “first and second gill arch syndrome”. Currently, the modern ear reconstruction method using autologous rib cartilage as the raw material and placing the ear stent in the mastoid area is considered to be the most effective treatment method. When is the best time for surgery? Most parents of children are concerned about the psychological stress that a missing ear can cause. However, the degree of development of the rib cartilage makes it necessary to perform the ear reconstruction surgery when there is sufficient raw material for the ear support. Currently, the nationally and internationally recognized conditions for surgery are: 6 years of age, 120 cm of elevation, and a chest circumference of 57 cm. As the body develops, the amount of rib cartilage increases dramatically, so the rib cartilage of children older than 6 years of age is more conducive to ear scaffolding, and the results tend to be better after the surgery. This is one of the reasons why the shape of the reconstructed ear at the age of 8 – 10 years is mostly satisfactory. However, after the onset of puberty, the rib cartilage begins to calcify and hardens to a point that is not conducive to ear scaffolding. Therefore, the optimal time for reconstructive ear surgery is between the age of 6 and puberty.