Rib Graft

Rib Graft Ear Reconstruction

The traditional method of ear reconstruction is Rib Graft.  Rib Graft reconstruction uses tissue from the patients own body and involves making an ear framework from the patients rib cartilage (which is taken from the patient’s rib cage).  This technique has been used for the past 50 years.  In Australia, this surgery is usually performed in 2-3 stages i.e. 2 or 3 separate operations.

During the 1st surgery, cartilage is harvested from the rib cage.  The cartilage from about 3 ribs is removed and carved into a framework which is designed to resemble the other ear.  A skin pocket is formed, into which the cartilage framework is placed.  The ear lobe that is usually present is repositioned into its normal position.  A suction drain is placed to encourage the skin to re-drape over the framework, and the skin is closed.

The second stage of the ear reconstruction, which involves elevation of the created ear from the side of the head, is performed several months after the first stage.  Sometimes your child may require surgery to pin back the other ear to more closely match the reconstructed one.  Another minor stage may be required to adjust an imperfection or add further features to improve the reconstruction.

Ear framework sculpted from rib cartilage

Rib graft ear reconstructions are generally performed at 8-10 year of age.  By this time, the child is usually large enough that rib size is sufficient to harvest an adequate rib graft.   This is only a guide as there are several factors to be considered.  If the child is still small, surgery may be postponed until adequate rib for the framework can be harvested.

Surgeons have personal preferences as to the ideal age to begin this surgery. Some may consider operating a little earlier, and some may opt to wait a little longer.  This is something that you will need to discuss with the surgeon that you choose.  Age of surgery depends on the amount of rib cartilage the child has and the rib graft technique the surgeon uses.

If your child is a candidate for atresia repair (to create an ear canal) and you choose to have this surgery, it should be done after the rib graft ear reconstruction.

The best known Rib Graft ear reconstruction surgeons in the world include Dr Burt Brent (USA), Dr Arturo Bonilla (USA),  Dr Satoru Nagata (Japan), Dr Françoise Firmin (France), Dr Neil Bulstrode (UK).

Australian surgeons who have the most experience in this technique include

Dr Stuart Bade (Brisbane)

Dr Nicholas Lotz (Sydney)

Dr John Vandervord (Sydney)

Dr Andrew Greensmith (Melbourne)

Dr Chris Coombs (Melbourne)