Objective To observe and evaluate the clinical effect of and experience in total auricular reconstruction with Medpor polymer polyethylene artificial ear framework implantation. Methods A total of 1 057 patients (1 063 ears) with microtia accepted auricular reconstruction from May 2003 to June 2021 in our department were included. The surgical methods and success rate, scores of symmetry and fine structures of the auricle, patient satisfaction, surgical complications together with hearing improvement were evaluated. Results All patients had been followed up for 6 months to 16 years postoperatively, successful reconstruction of all the 1 063 ears was achieved, and the auricle shape recovered well gradually. Scores of seven auricle symmetrical indexes were all more than 5. The proportion of the score of 14 fine structures in the auricle more than 10 was 88.90% (945/1 063). The overall satisfaction rate of patients was 92.00% (978/1 063). Patients undergoing simultaneous hearing reconstruction obtained varying degrees of hearing improvement. Conclusions Medpor implantation is clinically safe and feasible for the treatment of the congenital microtia, which can be used as one method of auricular reconstruction. Besides, simultaneous hearing reconstruction can be performed, which not only makes the reconstructed auricle more realistic, but improves the patient's satisfaction rate.