Severe cases of microtia or anotia are usually combined with a blind external auditory canal and defects of the contents of the middle ear. Impairment of hearing of the involved ear is always present. The rational treatment of this congenital acoustic deformity should restore not only the form but also the function of the ear. To achieve this, plastic surgeons must co-operate closely with an otologist. Nevertheless, such an attempt of co-operation has seldom occurred. In this paper we describe two procedures for total ear reconstruction together with the restoration of auditory function: one is two stage and the other one stage. During the operation, a tympanoplasty is performed before tranplantation of the carved cartilage framework. The principle and main points of these two procedures are discussed.