Table 3 Long-term limitations of autologous auricular reconstruction

Stiffness

1. Different biomechanical properties of fibrocartilage donor [23]

2. Heterotopic calcification [23, 65]

Extrusion

1. Skin flap necrosis [37]

2. Wire sutures to assemble cartilage framework [36, 37]

3. Wound infection or pressure dressings [28, 64]

Projection loss

1. Effacement of postauricular sulcus due to contraction of skin grafts [37, 67]

Distortion

1. Constriction of skin and soft tissue overlying the construct due to scarring or ischaemia [37]

2. Cartilage degradation and resorption leading to loss of definition [64, 66, 67]