BACKGROUND: This study introduces a construction method for a multilayered three-dimensional costal cartilage auricular framework and retrospectively analyzed its clinical effectiveness in auricular reconstruction with an expanded postauricular skin flap. METHODS: We designed multiple techniques for constructing a multilayered three-dimensional costal cartilage auricular framework to enhance stability and aesthetic outcomes. Postoperative follow-up included a comprehensive morphological assessment of the reconstructed ears, as well as evaluations of postoperative complications and patient satisfaction. RESULTS: The study collected data on 75 patients who underwent auricular reconstruction in our department between January 2021 and December 2022, totaling 81 ears. During the follow-up period of 1 to 2 years postoperatively, plastic surgeons conducted a comprehensive morphological assessment of the reconstructed ears. Of these, 64 ears (79.0%) were rated as having good morphology, 13 ears (16.0%) as moderate, and 4 ears (4.9%) as poor. A survey on patient satisfaction revealed that 62 patients (82.7%) were satisfied with their reconstructed ears, 11 patients (14.7%) found the results acceptable, and 2 patients (2.7%) deemed them unacceptable. Postoperative complications included infections in 2 ears (2.5%), hematoma in 1 ear (1.2%), cartilage framework exposure in 3 ears (3.7%), and hypertrophic scarring in 5 ears (6.2%). There were no instances of skin flap necrosis, frame deformation, absorption, or wire exposure during the follow-up period. CONCLUSIONS: The multilayered three-dimensional costal cartilage auricular framework we constructed for auricular reconstruction with an expanded postauricular skin flap resulted in the majority of reconstructed ears maintaining a satisfactory shape, with clear substructures, lifelike morphology, and strong three-dimensionality. Patient satisfaction with the surgical outcomes was high, achieving good stability and aesthetic effects.