Sculpting a New Ear : A Series of Reconstructive Surgeries Gives Westminster Girl What Nature Did Not

This holiday season, 7-year-old Michelle Filkoff’s parents gave her a gift they had been planning since she was born: a new outer ear.

The youngster was born with a birth defect called microtia that afflicts one in about 7,500 children, causing one or both ears to be missing or misshapen. But recently, the energetic first-grader had the final stitches removed from her reconstructed right ear, after the last of four surgeries that began when she was 5 years old.

“When I saw the results of the last surgery, I just broke down and cried,” said Michelle’s mother, Arlene Filkoff. “I was finally able to give her something I couldn’t give her at birth. This is a very special holiday for us.”

Michelle’s ear reconstruction was the 1,000th such surgery for Dr. Burt Brent, a plastic surgeon based in Mountain View, in Northern California, who is recognized as one of the foremost ear reconstructive surgeons in the world. Using a technique he developed, Brent removed cartilage from her ribs, sculpted it into the shape of an ear and inserted it under her skin.

In later surgeries, extra skin was grafted to the ear to help define it, and an earlobe was added.

“I love my new ear,” Michelle said, beaming and displaying the new appendage proudly. “I’ll be able to get both of them pierced next year.”

When Michelle was born with a small, misshapen piece of skin where her right ear should have been, her parents consulted local pediatricians. They were referred to Brent, whose work blends his lifelong love of art, sculpture and medicine.

A surgeon at El Camino Hospital in Mountain View and associate clinical professor of plastic surgery at Stanford University Medical Center, Brent gained prominence in the late 1970s when he operated on kidnap victim J. Paul Getty III, whose ear was severed by captors after their demands for $3.5 million from his father were not met.

After performing a series of tests when Michelle was a toddler to make sure her tissues would be compatible with the procedure, Brent said, he agreed to perform the first operation when she was 5 years old. The human ear is about 85% developed by age 6, and the reconstructed ears actually grow, Brent said.

Before the surgeries, Brent prepared the family for the various psychological difficulties that Michelle later experienced, including a loss of confidence and self-esteem. “The kids at school would make fun of her,” Arlene Filkoff said.

But since the surgery, “there’s been a marked emotional change,” her mother said. “Before the surgeries, she would refuse to brush her teeth, wash her face, anything that involved standing before a mirror. But when we came home after the operation, we couldn’t get her out of the bathroom for 45 minutes. We were really astounded by that.”

Because she is mostly deaf in her right ear, Michelle becomes confused by the sounds of large groups at school or at parties. Her family is planning to travel to Virginia next summer for an operation to unblock her inner ear and restore almost full hearing, they said.

Despite her condition, Michelle has shown a surprising aptitude for music and often composes and sings songs at the piano, said her father, Michael Filkoff.

The ear surgeries cost about $80,000, the Filkoffs said; their insurance paid about 80%. “It’s been a stretch for us, but if it had cost more, we would have paid more,” Arlene Filkoff said.

Brent and the Filkoffs said they chose to discuss Michelle’s operations publicly to give hope to others with her condition.

“It changes the life of the entire family, and that’s the real beauty of this,” Brent said. “The kid is being ridiculed by peers, and the family is often harboring lots of guilt because they feel like it’s their fault. But when you do this properly, the guilt dissipates and confidence returns. It’s the thing that keeps me going to work every day and loving it.”