A medical team at a hospital in Edinburgh is constructing new ears for Kade Romain, who lived in an orphanage before coming to Scotland.
Ear specialist Ken Stewart has been carrying out the operations at the Spire Murrayfield Hospital in Edinburgh.
"We're going to release the ear from the side of her head and re-create the groove behind the ear by taking a skin graft and putting that skin graft behind the ear," he says as he prepares for the surgery.
Kade's new ears were constructed from cartilage taken from her ribs.
The ear structures were positioned under flaps of skin on either side of her head.
Now that the scars have healed and the swelling has settled down, Mr Stewart can perform this second stage to make the ears "stick out" slightly.'Self confidence'
Kade is already wearing her hair pulled back from her face for the first time. A hearing aid has also helped her learn to speak English, and hear sounds she has never heard before.
"I can hear the sounds of the sea," she says.Kade, who was born without ears, has undergone a second round of surgery in Scotland
Her guardian Robina Addison is delighted with the progress.
"She's got so much more self confidence now," she says. "She's gone from hiding behind her hair or a hat to not caring who sees her ears."
Mrs Addison, a Scottish dance teacher, first met Kade in an orphanage in Trinidad.
Kade couldn't attend school because of her deafness and was attending a day unit for children with mental handicaps, despite the fact her disability didn't affect her intelligence.
Mrs Addison was inspired to organise a temporary visa for Kade to come to Scotland for the unusual operation.
The surgery would normally offered on the NHS but as Kade is a foreign national she does not qualify for free health care.Continue reading the main story
Kade had a chronic infection that we weren't aware of deep inside her ear ”End Quote Ken Stewart Ear specialist, Spire Murrayfield Hospital Instead the Spire Murrayfield private hospital offered its facilities and the surgical team has worked for free.
It hasn't all been straightforward. Kade's newly constructed left ear had to be removed when she developed an infection caused by botched surgery in Trinidad to try to drill a new ear canal.
"She's about as complicated as ear reconstruction gets," says Mr Stewart.
"Kade had a chronic infection that we weren't aware of deep inside her ear, so we had to remove one ear and temporarily bank the cartilage in her chest for safe keeping."
The infection has now been treated and the ear removed from between her ribs and reinserted under skin on the left side of Kade's head.
Kade will eventually be fitted with a permanent bone-anchored ear canal.'Lovely future'
Since arriving in Mrs Addison's home town of Montrose, Kade has attended school for the first time and has made friends with other pupils.
"She's now learning to read and write," Mrs Addison says. "She works hard and tries hard to be 'more clever', as she puts it."
Mrs Addison and her husband now hope to adopt Kade permanently.
"Eventually the hearing aid won't be visible at all and she's going to be a completely new person. I'm sure Kade's going to have a lovely future."