The Causes and Effects of Microtia

Microtia is not life-threatening, but when your little one is missing all or part of an ear, it can significantly impact his or her hearing. Microtia can take a toll on your child’s appearance and self-esteem, as well. As a parent, you may feel overwhelmed, unaware of your options and unsure of the best way to care for your child. Located in Beverly Hills, CA, Reinisch Plastic Surgery is a world-renowned leader in the treatment of this condition. Dr. John Reinisch pioneered the innovative MEDPOR technique, which provides better cosmetic results than older methods of ear reconstruction. He can also combine this surgery with ear canal reconstruction to address aural atresia. Patients come from across the country and around the world to benefit from his expert care.

What Is Microtia?

What is Microtia?Microtia is a congenital disorder. Children born with the condition have a small, irregularly shaped, or missing ear. In 90 percent of all cases, it only affects one ear, although some patients have bilateral microtia. There are four grades of the condition:

  • Grade 1: An unusually small ear, often with a narrowed or missing ear canal.
  • Grade 2: An abnormally developed outer ear, especially the upper half, often with a narrowed or missing ear canal.
  • Grade 3: A small, abnormally developed outer ear with no ear canal. This is the most common form of microtia.
  • Grade 4: A missing ear and ear canal.

Fortunately, Dr. Reinisch offers several advanced surgical techniques that can correct microtia. These various methods can both reconstruct a patient’s ear and restore his or her hearing. A leading expert in his field, Dr. Reinisch has coauthored a book on this topic with plastic surgeon Youssef Tahiri. Entitled Modern Microtia Reconstruction, it will be published by Springer in 2018.

Dr. Reinisch educates parents regarding the different treatments, as well as the advantages and disadvantages of each.

About Aural Atresia

About Aural AtresiaMany patients with microtia also suffer from aural atresia, which causes a narrowed or missing ear canal. In a normally developed ear, sound waves travel through the ear canal. They then create vibrations in the ear drum, ear bones, and the fluid inside the inner ear. The brain receives these vibrations as electrical impulses, which it translates as sounds. When sound waves are not able to move down the ear canal normally, patients often have difficulty distinguishing individual sounds and separating them from background noises. Those with untreated aural atresia may have difficulty hearing and communicating well in school, parties, and other noisy environments. As a result, the condition can also contribute to speech impediments and language difficulties. Dr. Reinisch offers several treatments for aural atresia. He works with a top otologist who can often create an ear canal and ear drum for the most comprehensive results. Dr. Reinisch encourages parents to seek treatment as soon as possible so that their children can process and learn language skills at an equal pace with their peers.

Causes of Microtia

Causes of MicrotiaScientists are still unsure about the causes of microtia. However, they do know that it is not tied to pregnancy-related factors. Many parents worry that they could have done something to prevent this condition, but microtia is truly a biological accident. It is not passed down genetically, and because it is so rare, prenatal ultrasounds typically cannot detect it. Microtia affects approximately one in every 8,000 to 10,000 babies born in the U.S. Other regions, particularly China, South America, and Central America, have higher microtia rates. Dr. Reinisch is internationally known as an expert in this condition. He regularly treats patients from around the world. To better serve our diverse patient base, our staff is fluent in Spanish, English, Mandarin, Italian, Russian, and Hungarian. 

Microtia Treatment Options

If you are seeking the most effective treatment for your child’s microtia, you have several options available to you. Rib cartilage reconstruction is the oldest method. It involves taking tissue from a child’s chest and using it to create a new outer ear. Unfortunately, Dr. Reinisch cannot perform this technique on children under the age of eight because of the risk of chest deformity.

To enable earlier treatment and to provide better esthetic results, he developed the MEDPOR technique. This method uses a biocompatible polyethylene implant to create a framework. Then Dr. Reinisch places a skin graft over the implant, resulting in a sturdy, natural-looking ear. This method requires just one outpatient surgery, making it less costly and less stressful for children and their parents alike.

If your child does not qualify for either of these two methods, Dr. Reinisch can refer you to a specialist for a silicone prosthetic ear.

What to Expect after Microtia Treatment

The MEDPOR technique typically requires just one surgery. In some cases, however, your child may require a second procedure for cosmetic reasons. During this latter minor surgery, Dr. Reinisch will reshape the earlobe. Thanks to his skill, your child should experience minimal discomfort after MEDPOR surgery. In fact, most patients simply require Tylenol® or similar non-prescription medications. For three weeks, your child will need to wear a special cup to protect his or her new ear. You should expect the ear to be somewhat red and swollen. You will also see scars from the skin graft. Fortunately, redness should subside within two weeks, and scars will begin to fade after that. In about six months, the new ear should be fully developed.


MEDPOR can dramatically improve the appearance of an ear affected by microtia.

MEDPOR ears function just like natural ears. After the initial healing period, your child should be able to engage in normal activities, including sports, just like his or her peers. Of course, it is always possible for an ear to become damaged. However, the risks are just as high for biological ears. The implant will not grow. Accordingly, your child’s ear will remain the same size for life. The earlobe will develop normally, corresponding to the lobe on the opposite ear.

The Cost of Microtia Treatment

Microtia treatment is typically covered by insurance. Our office staff is happy to work with your provider to help you obtain the maximum amount of coverage. At the same time, we are passionate about treating patients of all backgrounds, including those from other countries and those without insurance. To better meet your needs, we offer various forms of financing and monetary assistance. We accept CareCredit® and can help you apply for an appropriate plan. Dr. Reinisch also founded the Small Wonders Foundation. This non-profit organization is dedicated to helping the families of children with congenital defects. To serve our long-distance patients, we partner with the Ronald McDonald House, providing housing to family members as their children recover from surgery. We also have number of area host families. All traveling families will receive a complimentary two-night stay at the Four Seasons. If you are concerned about the cost of treatment, please talk to our friendly staff who would be happy to answer your questions.

We Can Answer Your Questions

Parent’s Guide to Microtia

When your child has microtia, it is easy to be overwhelmed with the number of surgical options available. Dr. Reinisch educates parents regarding the different treatments, as well as the advantages and disadvantages of each. He wants you and your child to be comfortable with the treatment that you select, and he will guide you as you make important decisions that will affect your little one’s future.

Microtia Frequently Asked QuestionsYou may be unaware of the range of medical specialists involved with microtia treatment. You may also have concerns regarding how to talk to your child about the condition. Perhaps you are wondering why you should choose surgery for your child when he or she is perfectly happy with a small ear. Maybe you are confused about why this congenital deformity was not picked up during a prenatal ultrasound. Dr. Reinisch and his team are always happy to answer your questions and address your concerns in detail.

Contact Reinisch Plastic Surgery

If your child is suffering from microtia, we are ready to provide the compassionate care that he or she deserves. Contact us online for more information or to book an appointment. You can also call us at
(310) 385-6090.

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Reinisch Plastic Surgery

Beverly Hills Office (310) 385-6090