Dr. John Reinisch pioneered ear reconstruction with a porous polyethylene (PPE) implant in 1991. It is now the most advanced surgical treatment for microtia, and the foundation of the combined approach offered through the Learn Microtia program.
The implant is a microporous, high-density polyethylene framework designed to reconstruct the outer ear. It is biocompatible, meaning the body’s own blood vessels and tissue grow into the material, so it heals naturally and isn’t rejected.
Each implant is customized to match the shape and projection of the patient’s opposite ear, for a natural-looking ear and good symmetry.
When Dr. Reinisch began treating microtia, the standard method was to carve an ear from rib cartilage, and it had barely changed in decades. It worked, but children had to wait until they were nearly ten, go through several operations, and live with a scar on the chest. He set out to find a better way, with three goals: a more refined ear, less pain, and treatment early enough to finish before school. Since introducing the technique in 1991, he has refined it continuously.
Why do many families and surgeons now prefer implant reconstruction to traditional methods.
Dr. Reinisch typically completes implant ear reconstruction in a single procedure. Traditional rib cartilage methods require at least two separate surgeries. One surgery means less time under anesthesia, less disruption to the family, and faster results.
Usually, implant ear reconstruction is performed as an outpatient surgery. Patients typically go home the same day, with a recovery focused on comfort and protective care of the surgical site.
Because this method does not require harvesting rib cartilage from the patient’s body, there is no donor site, no chest scar, and significantly less post-operative discomfort. Light activities can usually resume within days.
We offer a combined approach in which cosmetic appearance and functional hearing can be addressed at the same time. This can be either a canalplasty (CAM: Combined Atresia Microtia repair), or the placement of a hearing device.
| Implant Reconstruction | Rib Cartilage | |
| Number of surgeries | Typically 1 | A minimum of 2 |
| Earliest age | ~3 years | ~8–10 years |
| Donor site scar | No | Yes (chest) |
| Hospitalization | Outpatient (same-day) | Usually 1-3 days |
| Recovery pain | Minimal | Moderate |
| Hearing restoration in the same session | Yes (with CAM or device) | Requires a separate procedure |
| Post-Surgical Drains | No | Yes |
MEDPOR was the original PPE ear implant, and its name became shorthand for the whole category, the way “Kleenex” did for tissues. Today we use newer PPE implants such as Omnipore and Su-Por, which evolved from the original MEDPOR design.
Implant reconstruction suits most people with an incomplete or missing outer ear:
What matters most is healthy tissue to cover the implant.
The framework is wrapped in a thin, living layer of tissue called fascia. Its blood supply usually comes from an artery in the temple, or from one at the back of the head. Dr. Reinisch checks this at the consultation.
Some things rule out rib cartilage reconstruction, such as a low hairline, scarring behind the ear or earlier canal surgery. They often don’t rule out an implant, as long as there’s enough healthy tissue to cover the framework.
Before surgery, Dr. Reinisch plans the new ear around the one your child already has.
There are two complementary parts to treatment for microtia — understanding what each one addresses is the single most useful thing you can do at this stage.
About 4–5 hours. It’s done under general anesthesia with an experienced pediatric anesthesiologist, and most children go home the same day.
The implant is shaped to match the plan. Dr. Reinisch then lifts a thin layer of living tissue, called fascia, from under the scalp through the same incision used for the ear, so there’s no extra scalp incision. He wraps the framework completely in this tissue and covers it with a thin skin graft. A soft silicone cover holds the new shape while early healing begins.
Never on the operated side. Many parents sleep beside a young child for the first two weeks so they can gently reposition them during the night.
No, they dissolve on their own. From about week three, gentle washing with a gauze pad helps them come away.
Serious complications are uncommon, and Dr. Reinisch goes through every risk with you at the consultation. Swelling and bruising are expected and settle over the first weeks. Fluid sometimes collects under the scalp early on and is drained easily at a follow-up visit. If the covering tissue thins, a small part of the framework can show through; this is usually repaired with a minor procedure. Infection is uncommon and usually treated with antibiotics. Occasionally a small revision refines the shape or projection.
