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To explore a novel approach, associated balancing surgical treatments of the first and second branchial arch syndrome and to supply an array of practical, efficacious, and relatively shorter course of treatments for clinics.For microtia with severe ipsilateral facial dysplasia with the first and second branchial arch syndrome, auricular reconstruction using traditional methods by autologous cartilage framework and filling of the malar region and the mandible with an autologous rib for the ipsilateral zygomatic arch and the mandibular bone were begun to correct ear and jaw deformities. The second stage is turning over the auricular flap and skin graft with autologous fat transplantation to reshape facial contours.Six patients were followed up for 3 to 9 months postoperatively. All of them showed satisfactory surgical results with no adverse effects. The shape of the reconstructed auricle and the affected hemifacial region improved greatly. Good stereopsis with symmetry was observed on the whole. The implanted rib and the cartilage frameworks were not deformed, absorbed, or exposed. Transplanted fat particles were observed with no infection, scleroma, subcutaneous mass, cyst, or other complications.This method is well designed and easy to perform. The satisfactory effects and few known complications make it one of the most effective treatments of the first and second branchial arch syndrome.