Reconstruction of the pinna must be adapted for each individual case. Surgical techniques which use autologous costal cartilage are the most reliable. During the 1970s Burt Brent described a technique in 4 stages which gives very good results. More recently, Satoru Nagata has proposed total reconstruction of the pinna in two stages. For cases where there is insufficient spare skin, a tissue expansion prosthesis may be used in cases with extensive scarring and fibrosis, the superficial temporalis fascia flap is useful. Bone-anchored prostheses are reserved for those cases in which surgery is contra-indicated for general reasons. Based on our experience of 119 reconstructions of the pinna, we discuss the various techniques which may be used.