Review PaperThe History of Alloplastic Ear Reconstruction for MicrotiaKozusko, Steven D. MD, MEda; Konofaos, Petros MD, PhDb; Wallace, Robert Doyle MDbAuthor Information From the aDivision of Plastic Surgery, Cooper University Hospital, Camden, NJ bDepartment of Plastic Surgery, University of Tennessee Health Science Center, Memphis, TN. Received June 30, 2019, and accepted for publication, after revision October 28, 2019. Conflicts of interest and sources of funding: none declared. Reprints: Petros Konofaos, MD, PhD, 1068 Crersthaven Rd, Suite 500, Memphis, TN 38119. E-mail: firstname.lastname@example.org. Annals of Plastic Surgery: July 2020 - Volume 85 - Issue 1 - p 89-92 doi: 10.1097/SAP.0000000000002213 Buy Metrics Abstract Microtia reconstruction is a unique and challenging field in reconstructive surgery. In the early 20th century, many different alloplastic materials have been used in an attempt to recreate the fibrocartilaginous framework of the native ear. These materials include celluloid, tantalum wire cage, nylon mesh, polyethylene, and acrylic. The first standard for alloplastic microtia reconstruction, silicone, is one fraught with complications and failures. This alloplastic material is walled off by the host and prone to scar tissue formation and extrusion. Alloplastic microtia reconstruction largely shifts to porous polyethylene, where the results are markedly superior. This is attributed to the porous structure of porous polyethylene, which allows tissue ingrowth. Moreover, the use of the temporoparietal fascia flap for total coverage of the implant has impressively lowered the risk of implant extrusion. However, there is paucity in the literature regarding the evolution of alloplastic microtia reconstruction, especially characterizing historical mistakes, significant technique evolutions, and drawbacks/advantages of materials. This review serves as a guide both to avoid repeating mistakes and to improve outcomes. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.