Rib Graft vs. Medpor

For individuals interested in surgically reconstructing the outer ear, there are two methods: the Medpor method and the rib graft method.  Surgeons who specialize in microtia repair either do one method or the other.  There are, of course, the options of (1) leaving the ear as it is or (2) using a prosthetic ear (these actually look the best a lot of the time).

A short summary of the timing and key differences for the two methods:
  • MEDPOR APPROACH:
    • The Medpor approach uses a synthetic medpor frame to create the shape of the ear.  The main disadvantage is concern that if the ear is traumatized through an accident or sports and the ear is cut, the medpor could be exposed and necessitate surgery to repair.
    • If the patient is going to have canalplasty, the canalplasty surgery happens first, then the medpor microtia repair follows.  Surgery can begin as young as three years of age.
    • This method is much newer than the rib graft method, so there aren't examples of people who have had the medpor framework for 20+ years like there are for rib graft.  However, medpor has been used in bodies for a long time; and medpor seems to last.
    • The medpor method requires one surgery and sometimes a "touch up" surgery to further develop the tragus.
    • Dr. John Reinisch is the pioneer of the medpor method.
    • We used Dr. Sheryl Lewin who has amazing skill and a wonderful bedside manner and way of connecting with kids. 
  • RIB GRAFT APPROACH:
    • The rib graft approach has been used for a much longer period of time and has a long-term track record of success.  It uses the individual's own cartilage (from between the ribs) as the framework of the ear, so any injury to the ear would heal the way the body heals.
    • If using the rib graft approach to microtia repair, the microtia repair happens first and then the canalplasty follows.  Because this method requires that the cartilage be large enough to be sculpted into an ear frame shape, the child must be at least 6-8 years of age to start surgery.  Removing the cartilage essentially requires one more "step" than the medpor approach - but the benefit is the 100% organic origins of the framework.
    • Having a skilled and experienced surgeon is critical for both approaches, but it's particularly important for the rib graft approach because the cartilage framework is carved by the surgeon during the surgery.
    • The rib graft method usually requires 2-4 surgeries.
    • Dr. Burt Brent is arguably the best and one of the modern day pioneers of the rib graft method.
The aesthetic results and differences between the two approaches are largely dependent on the surgeons and their level of experience and skill.  To have an idea of what you/your child could look like, you'd have to look at results of the surgeons you would use.  The following are some of the best examples:
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