Most of the world’s microtia surgeons make an ear by sewing together multiple pieces of rib cartilage, or by melting two standard pieces of Medpor together. However these techniques are both limited because they can’t recreate all of the subtle, complex and delicate 3-dimensionality of a natural ear.


Dr. Lewin has developed a new technique to create a realistic 3-dimensional ear that mirrors a patients own anatomy



 The 3D Scan

Dr. Lewin scans Jadyn’s ear for her sister who has bilateral microtia.

In 2018, Dr. Lewin started using a high-resolution 3D scanner based on blue light technology to create a precise mirror-image of a patient’s natural ear. Dr. Lewin performs the 3D scan in her office or at our Earicles Conferences. It is an easy, painless study done in a few minutes while the child is awake. The scan eliminates the need to sedate a child for expensive CT or MRI scans.

Dr. Lewin scans Jadyn’s ear for her sister who has bilateral microtia.→

The scanned 3D ear image is a nearly perfect replica of the patient’s “big” ear. The 3D scan is then modified based on each individual’s anatomy. The ear implant is made thinner than the natural ear to account for the thickness of the flap and skin that covers it. The implant design is also enlarged to each child’s predicted adult size.



The 3D Lewin Ear Implant by Su-Por

The final 3D ear design is then sent to Su-Por, where the digital data is transformed into an intricately detailed, patient-specific sterile implant. This incredibly efficient FDA-approved process creates the ear implant from a single piece of high-density porous polyethylene.

The 1-piece design creates a much more realistic and much stronger implant, essentially eliminating the risk of fracture seen with traditional 2-piece (Medpor) implants. Dr. Lewin then sculpts more details into the implant in the operating room where she can directly compare it to the child’s natural ear. Notice the implant is larger than the ear to account for the child’s future growth.


Dr. Lewin was the first surgeon in the world to bring this technology to daily clinical use and now nearly all of her patients are receiving Lewin Ear Implants.



The “Key to Success”

As exciting as the 3D Lewin Ear Implant is, what covers the implant is actually THE MOST IMPORTANT ELEMENT of ear reconstruction.

Why? Because the biggest challenge in Porous Implant Ear Reconstruction (PIER) is the “TPF FLAP”–the living membrane that covers the ear implant. This technique is even more challenging with the increased detail of the 3D implant. A HIGH DEGREE OF SKILL and EXTENSIVE EXPERIENCE are critical to obtain the flap, as the surgeon must be adept and inventive with difficult anatomy. The flap must be PERFECT to get a beautiful and durable ear. If it isn’t, the appearance of the ear will suffer and complications such as an exposure may occur.

The TPF flap is so thin it is translucent. The delicate tissue containing blood vessels and nerves must be painstakingly dissected away from the overlying scalp. The flap does not grow back, but there are several more layers of tissue below the flap.

The flap is placed around the 1-piece implant and suction is applied to achieve the exact shape of the ear implant. The flap grows into the pores of the implant and nourishes the skin placed on top of it.

How does the 3D Lewin ear heal?