Abstract: Objective: To investigate the causes of flap necrosis after the secondary operation for auricle reconstruction. Methods: Auricle reconstruction was performed using soft tissue skin expander and autogenous rib cartilage framework. All or part of the auricle flap necrosis occurred in four patients in the early stages. The causes of the necrosis were analyzed in-depth. Results: Flap necrosis was dry, and caused by arterial insufficiency. The necrosis was mainly caused by improper design and operation. Conclusions: The operation method is modified based on the causes of flap necrosis and the occurrence of similar situations is avoided.