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The expander was further removed, and then enveloped by the expanded flap, retroauricular fascial flap and a free skin graft. In the third stage, the reconstructed ear was further trimmed, including lobule transposition and tragus reconstruction. The patients were followed for 6 months to 7 years. There were 63 cases (91.3%) responded satisfied outcomes in size, shape, position and bilateral symmetry. One case suffered expander leakage and tissue expansion accomplished after the expander was replaced. Hematoma was occurred in four cases and removed to compl