Doctors in London have built a complete ear for a boy born with a congenital disorder using bone and cartilage from one of his ribs.
Ten-year-old Alfie Hazell, was born with a condition called hemifacial microsomia - a congenital disorder affecting the development of the lower half of the face.
With no ear canal or ear structure on the left side of his face, Alfie has been bullied for most of his young life. The condition is the second most common facial birth defect, after clefts. It normally affects the ears and mouth and can cause issues for a child's breathing.
The options for children born with the disorder are to be fitted with a prosthetic ear, have a new ear grafted using a rib, or to do nothing.
Alfie's parents, Catherine and Ben Hazell, let him make the decision himself after talking with doctors. Mrs Hazell told the Daily Mail, "I was keen that Alfie was able to make the decision himself. Ben and I encouraged him to speak to consultants directly during appointments, as if he was one of the adults."
However, the family were told by doctors that Alfie would need to wait until he was nine years old to begin the procedure because they needed to allow his ribcage to develop. In 2011 Alfie made the decision to go ahead with the procedure.
The new ear was built during two operations at the Great Ormond Street Hospital in London. The first involved putting a section of one of Alfie's rib bones into place using rib cartilage. The second operation, completed in March this year, involved filling out the ear structure using skin grafted from Alfie's head.
Mrs Hazell says the new ear has changed Alfie's life. Since he was very young Alfie has been bullied and laughed at, Mrs Hazell said, "He has coped with people making comments about his appearance all his life. Ever since he was small he hid behind our legs when he met new people, and always hid his left side".
The new ear does not allow Alfie to hear, but he will have the option later in life to have a hearing aid implanted.