The second stage of the reconstructive surgery takes place approximately six to twelve months after the first procedure.

Again the child will be admitted to hospital on the same day of surgery. This second surgery will take approximately five to eight hours in the operating room and Dr. Kasrai and Dr. Fisher will perform the procedure together. During the surgery, the doctors will create a fold behind the reconstructed ear, and angle the ear properly. Some skin from the scalp will be taken to create an optimum colour match for the new ear. Any scars will be hidden in the hairline. Any cartilage banked from the first surgery will be returned to the rib cage through the old scar. This virtually eliminates any chest deformity. After the surgery - the child will be admitted to the recovery room and, after a brief time, taken back to the bed on the nursing unit. Pediatric nurses will care for the child on this unit for the next five to seven days, and the physicians will continue to visit daily to monitor the childs progress and address any questions by the family. Any touch ups required to attain optimum results will be made during this time.

As before, children are set up with PCA to manage any pain while in hospital. Dressings will be in place over the ear and over a small area on the chest and the child will again receive antibiotics to prevent infection.

After discharge from the hospital, patients will continue to visit Dr. Kasrai and Dr. Fisher in clinic for the following 2 weeks. Appointments will be set for every 1 to 2 days and sutures will be taken out at specific clinic visits. Antibiotics will continue throughout this period in order to prevent infection. Once all the sutures have been removed, patients are managed at home.

There is no special care required by families once the child is home. The precautions regarding refraining from sports and wearing a helmet are the same as for the first follow-up period.

Complications are rare, with some patients experiencing minor bruising. The surgical areas should be watched for swelling and redness. The areas should be kept as clean as possible until fully healed. Dr. Kasrai and Dr. Fisher are available at all times if there are any concerns. Every member of the team is involved in ensuring that the final results from the surgery are the best possible, and that any related health issues have been fully addressed. Family support is of key importance.