Purpose: Develop a composite pre-fabricated ear flap for reconstruction of auricular defects.

Materials and Methods The ear reconstruction entails two stages:

1st stage--A negative silicone mold of the ear defect is layered with acellular dermis. Rib graft is harvested and placed within the negative mold. This entire construct is then placed deep to the superficial temporoparietal fascia and aligned with a concomitant axial vessel.

2nd stage--Three months later, a cartilage-dermis-fascia axial pattern flap with the precise contour and dimensions of the original auricular defect (as translated by the silicone mold) is elevated and inset into the defect. The anterior surface of the flap has developed a vascularized neo-dermis for superior graft coverage.

Results: Traumatic ear defects were successfully reconstructed with this technique.

Conclusion: Ear reconstruction--particularly of large partial or microtia defects--is fraught with loss of structural definition and poor skin graft take on marginally vascularized surfaces. This pre-fabricated ear flap schema is a novel permutation of the traditional superficial temporoparietal fascia flap. It integrates silicone molds and acellular dermis to yield a composite, axial pattern ear flap which reconstructs the defect in precise, durable, three-dimensional fashion while maintaining robust vascularity on all surfaces.