Modifications of the total ear reconstruction technique allowing a two-stage procedure is described. However this is only possible if the soft tissue has not yet been damaged by previous plastic surgery or tympanoplasties. The framework sculpture is improved in order to obtain a posterior conchal wall at the first stage without using a skin graft. A tissue expander is used during the operative time in order to improve the framework coverage. A bone anchored hearing aid is preferred to tympanoplasty when necessary, for bilateral microtia. This method is effective and does not compromise the skin qualities. The osteointergrated implant is put in place during the second external ear reconstruction stage. The total hospitalisation period is no longer than 8 days.