ABSTRACT
In the reconstruction of facial defects, there are two competing approaches: transplantation of body tissue and the use of foreign material. Most clinics prefer either the one or he other technique, wich makes comparison difficult. At the Frankfurt University Medical School since 1992, cases of plastic surgical and prosthetic reconstruction of particularly difficult regions after orbital exenteration (n=13) and total auricular loss (n=5) were examined in relation to the medical literature, in order to enable a critical evaluation. Today, facial prostheses still are esthetically superior to plastic surgical reconstructions and need much less time and interventions. Age and general condition of a patient are important for the decision. In the case of the auricle, autologous reconstruction is preferred whenever possible. While facial prostheses are seen today in many cases as a practical means of rehabilitation which can help the heavily disfigured patient at short notice, the future, however, lies with autologous replacement despite the larger amount of work required