Microtia reconstruction has evolved significantly with advances in surgical techniques and biomaterials. Early reconstructive attempts by relied on soft tissue rearrangement with limited aesthetic success. Autologous costal cartilage frameworks were heavily popularised and considered a major advancement in auricular reconstruction. Recently with the introduction of porous polyethylene implants, a secondary alloplastic alternative has been provided. Understanding the historical progression of microtia reconstruction highlights the balance between aesthetic outcome, surgical complexity, and donor site morbidity that continues to guide modern reconstructive decision-making. Reference: Nagata S. Modification of the stages in total reconstruction of the auricle: Part I. Grafting the three-dimensional costal cartilage framework for lobule-type microtia. Plast Reconstr Surg. 1994 Feb;93(2):221-30; discussion 267-8. PMID: 8310014.