Soft Tissue repair is sometimes possible if a patient has an ear that is only mildly or moderately configured from normal. Tissue such as skin and cartilage can be ‘borrowed’ from behind the other ear and the mildly anomalous ear might be able to be expanded and redesigned – like origami with tissue. Depending on each individual patient and the specific ear, soft tissue repair can be performed as early as one year of age and older. Soft tissue repair has to be customized and depends on the configuration of each patient ear and whether the cartilage of the ear has the strength to hold sutures and can be flexible enough to work with. Soft tissue repair is typically an outpatient procedure and does not require an overnight stay at the hospital.
A variety of soft tissue reconstruction maneuvers can be employed to refine the shape and size of an ear that has some anatomical resemblance to a more normal ear. At times, all of the tissue is available at the site of the microtia ear. At other times, skin and cartilage (and even sculpted bone) from behind the other normal ear of the other side are transferred to use as donor grafts.
Cleft ear restored after soft tissue repair. 
Traumatic injury to left ear. 2 surgeries: local skin with buried silicone; ear lobe created from fat and skin flaps. 
One stage surgery with soft tissue repair and pierced ear lobe. 
A single stage left ear repair. 
Cupped ear restored in two stage procedure by soft tissue repair. 
Cryptotia. Ears did not appear to have superior portion of auricle. Both repaired in one stage. 
A cup ear deformity as part of CHARGE syndrome repaired with one operation. 
Two stage repair provided more natural external ear contours and an aural atresia repair.
Soft tissue repair has several advantages:
- the repair often is a single or two stage procedure
- often no donor site scarring is visible like for other types of reconstruction
- the procedure causes practically no pain
- the ear feels quite normal (a reconstructed ear does not feel normal with rib, or polyethylene , nor does a prosthetic ear feel normal)
- no drains are required
- at times reconstruction can be performed at an early age
- soft tissue reconstruction is compatible with later aural atresia repair (at times I do both the microtia and the aural atresia repair operations simultaneously)
Soft tissue repair has disadvantages:
- the most severe malformation, the “peanut” type of ear or type 3, is not ideal since a more substantial framework must be placed to create a full-sized ear.
- at times the reconstructed ear will look quite acceptable yet will not be a mirror image of the other ear (also true for rib and polyethylene reconstruction)
To make an appointment, e-mail us at: MicrotiaAtresiaClinic@VUMC.org or call ph: 615-343-6166.