Oct 20, 2018 at 03:31 pm

EMAIL FROM THE DR

Update posted by WEI LI GIEW

Hello! Thank you for your inquiry!

My name is Tiffany Wilke, and I am Dr. Lewin’s Microtia Patient Liaison. I am here to help Dr. Lewin explain the process of Microtia Ear Reconstruction Surgery. I have learned about this process firsthand, as I have a son with bilateral microtia and aural atresia who completed both of his ear reconstructions with Dr. Lewin.

*Yes, patients travel from all over the world for surgery with Dr. Lewin. In fact, we were looking at the clinic schedule in a week and noticed that our patients that day are from Indonesia, Korea, China, Ecuador, Alaska and Florida! Pretty amazing.

Dr. Lewin uses a newer surgery technique for ear reconstruction, called Porous Implant Ear Reconstruction “PIER” (Medpor, Su-Por), which was developed more than 20 years ago. This technique of ear surgery can be done as young as 3 years old and is actually much easier on patients and involves fewer surgeries, less scarring, and less pain than the more traditional technique of creating the ear from a patient’s rib cartilage. Although surgery can be done at 3 years of age, in light of recent recommendations regarding anesthesia in children under 4, Dr. Lewin prefers to wait until 4 years of age.

It is Dr. Lewin’s belief that the aesthetic result is better with PIER (at least in her hands) than can be achieved with the cartilage technique (see a comparison of these techniques at: http://microtiaearsurgery.com/treatment-microtia-ear-surgery/comparison-of-medpor-to-rib-cartilage). In particular, PIER is the treatment of choice for older patients who have unsatisfactory results after previous surgical attempts or ear loss due to trauma.

CONSULTATION WITH DR LEWIN
If after reading the details below you are interested in Microtia Ear Surgery, we suggest scheduling a Phone or Skype Consultation with Dr. Lewin (at no charge) so she can evaluate your specific case and answer your questions. Please email [email protected] with the Patient’s Name and Date of Birth to schedule this consultation.

The following information will explain the process of Microtia Ear Reconstruction Surgery (with Dr. Lewin’s PIER Technique) for international patients.

SURGICAL AGE
Surgery can be performed once a child turns 4 years old and can be performed at any age thereafter, including adulthood. Dr. Lewin and I believe there are many advantages to performing surgery at a very young age, including less anxiety about the surgery and less psychological trauma for a child to have 2 ears before starting school.

MICROTIA EAR RECONSTRUCTION SURGERY TIMEFRAMES AND FEES
The fees include all visits before and after surgery, and routine dressing supplies. The patient/family may be responsible for the cost of some medications or dressing supplies.

A non-refundable deposit of $7,500 is required to reserve a surgical date. The balance of the surgery fees are required to be paid in full one month before the surgery. Some international patients have international health insurance and can request a reimbursement for the cost of surgery. In this case, Dr. Lewin will be happy to provide you with a letter documenting all of the information requested for this purpose. Please note that the Microtia Ear Reconstruction Surgery fees listed below are effective now through December 2019. (*If you have had previous failed reconstruction ear surgeries, please let us know and we will provide you with the appropriate surgical fees.)

Microtia Ear Reconstruction Surgery Timeframes and Fees are different depending on if the patient has Unilateral (one ear) Microtia or Bilateral (both ears) Microtia.

UNILATERAL MICROTIA EAR RECONSTRUCTION SURGERY TIMEFRAME AND FEES
There are usually 1 or 2 surgeries required to complete the Microtia Ear Reconstruction Surgery for Unilateral Microtia patients. In some cases, the 2nd stage surgery is not necessary. Neither surgery requires patients to stay in the hospital.

1) 1st Stage Microtia Ear Reconstruction Surgery Timeframe
The 1st Stage Microtia Ear Reconstruction Surgery is approximately 8 hours of surgery time. Since the surgery is not very painful, patients go “home” the same day. Most patients only take a pain medicine for the first 1 to 3 days after surgery.

International patients must stay in California for one month after the 1st Stage Microtia Ear Reconstruction Surgery.

1st Stage Microtia Ear Reconstruction Surgery Fee
$16,000 USD Surgery Center Fee
$ 3,250 USD Anesthesiologist's Fee
$32,500 USD Dr. Sheryl Lewin’s Fee
------------------------------------------
$51,750 USD Total Fee*

*The Total Fee is $49,750 (a reduction of $2,000) if payment by cashier’s check, money order, or wire transfer.

2) 2nd Stage Microtia Ear Reconstruction Surgery Timeframe

The 2nd Stage Microtia Ear Reconstruction Surgery is much shorter and simpler than the 1st stage. It is recommended 6 to 9 months after the 1st stage. It is usually recommended to refine the ear and improve symmetry, but it is not always necessary. It is approximately 2 to 4 hours of surgery time.

International patients must stay in California for 5 to 10 days after surgery, depending on the extent of the surgery.

2nd Stage Microtia Ear Reconstruction Surgery Fee
Surgery Center Fee + Anesthesiologist's Fee + Dr. Sheryl Lewin's Fee is estimated to total: $15,000 to $35,000 USD**

**The 2nd Stage Microtia Ear Reconstruction Surgery Fee is variable as it is calculated on an hourly rate, based on the number of surgical hours.

BILATERAL MICROTIA EAR RECONSTRUCTION SURGERY TIMEFRAME AND FEES
There are usually 3 surgeries required to complete both Microtia Ear Reconstruction Surgeries for Bilateral Microtia patients, two 1st Stage surgeries (Right Ear, Left Ear) and one 2nd Stage surgery (Both Ears). In some cases, the 3rd surgery is not necessary.

The Timeframes and the Total Fees for EACH EAR are listed above with Unilateral. Therefore, a Bilateral Microtia patient would pay double the 1st Stage Microtia Ear Reconstruction Surgery Total Fee and one 2nd Stage Fee:

Surgery 1 (Right Ear): 1st Stage Microtia Ear Reconstruction Surgery Total Fee
$51,750 ($49,750 with payment by cashier’s check, money order, or wire transfer)

Surgery 2 (Left Ear): 1st Stage Microtia Ear Reconstruction Surgery Total Fee
$51,750 ($49,750 with payment by cashier’s check, money order, or wire transfer)
Surgery is performed 3 months after the Right Ear.

Surgery 3 (Both Ears): 2nd Stage Microtia Ear Reconstruction Surgery Total Fee
Estimated at $15,000 to $35,000 USD (variable as it is calculated on an hourly rate, based on the number of surgical hours).
Surgery is performed 6-9 months after the second 1st Stage surgery.

RECOVERY
The recovery after the 1st Stage Microtia Ear Reconstruction Surgery is variable depending on the individual, but most patients feel well after 3 days. Patients must keep the ear protected with a cup for the first 3 weeks. Although normal daily activities are fine after surgery, no strenuous activities should be performed for 6 weeks. The 2nd Stage Microtia Ear Reconstruction Surgery is much simpler and has a much shorter recovery time, usually about 1 week.

ADDITIONAL MICROTIA EAR SURGERY INFORMATION
If you want to see a video on how the surgery is performed, please go to: http://microtiaearsurgery.com/ (Featured Patient Videos)

If you want to read the most frequently asked questions about Microtia Ear Reconstruction Surgery, please go to: http://microtiaearsurgery.com/medpor-faq

If you would like to watch Dr. Lewin’s 2017 Microtia Atresia Conference lecture about Microtia Ear Surgery using the PIER technique, please go to: https://youtu.be/sYbSHo5KyS4

SURGERY CENTER
Surgeries take place at Cove Surgery Center, a new outpatient surgery center located next door to our new clinic office in Torrance, California. Cove Surgery Center was built to the highest standards of operating room facilities. The anesthesiologists at this surgery center have worked with Dr. Lewin on Microtia cases for many years; they provide an excellent and extremely safe experience for her patients. There are NO nurse anesthetists or anesthesia residents (doctors in training).

If the patient has a syndrome, other illnesses or issues with their airway (like Treacher-Collins Syndrome, sleep apnea, or heart/lung disease), the surgery may have to be done at an area hospital.

TRAVEL
Patients and their families are responsible for their own travel arrangements and accommodations while in California. Since patients recover quickly from these surgeries (usually they are back to themselves by 3 to 5 days after the procedure), most take time to travel and enjoy California while they are here.

SCHEDULING MICROTIA EAR RECONSTRUCTION SURGERY
A surgery date can reserved 1 year ahead of time. We will guarantee a month and the year of surgery on a first-come, first-served basis. Patients will be then put on a waiting list for the next available date. We will not commit to an exact date of surgery until 4 months beforehand. We do recommend reserving a surgery date 1 year ahead of time.

HEARING LOSS SURGERY
Dr. Lewin does perform surgery for hearing loss using Bone Anchored Auditory Processors (commonly known as BAHAs), but she does NOT perform the Atresia repair (canal reconstruction). In fact, Dr. Lewin developed a scarless technique for placing the titanium implant for BAHAs during the 1st Stage PIER surgery. This provides patients the ability to hear directly through bone conduction and is an excellent alternative to those that cannot have or choose not to have Atresia Repair. This also eliminates the need for an additional surgery with general anesthesia after the Microtia Ear Reconstruction.

If you want to watch Dr. Lewin’s Google+ Hangout On Air presentation on simultaneous Microtia Ear Reconstruction surgery (using the PIER technique) with Bone Anchored Hearing Device Implants followed by a live, interactive Question/Answer session at the end with online viewers, please go to: http://oticonmedical.wordpress.com/2014/05/27/dr-sheryl-lewin-discusses-microtia-ear-surgery-bone-anchored-hearing-devices/

For those patients who wish to have Atresia repair, Dr. Lewin does work closely with specialists who perform this type of surgery; they are called Otolaryngologists, specializing in Otology. There are specific requirements in how these surgeries for hearing loss (BAHA or Atresia repair) are coordinated with the outer ear surgeries, so this will be discussed extensively with Dr. Lewin. You may want to read more about these options by reviewing the 3 website pages listed at: http://microtiaearsurgery.com/hearing-loss/what-is-atresia

EARICLES MICROTIA ATRESIA CONFERENCES

To learn more about our educational conferences, please go to: www.microtiaearsurgery.com/mac

SOCIAL MEDIA
We are very active on social media and encourage Microtia Atresia families to connect with one another on our sites (social media links are below). Please follow us!
Again, thank you for contacting us. Dr. Lewin and we look forward to helping you in any way we can!

Warm regards,

Tiffany Wilke
Microtia Patient Liaison
Mother of Bilateral Microtia & Atresia child

Sheryl L. Lewin, MD, FACS
Craniofacial and Pediatric Plastic Surgery

23430 Hawthorne Boulevard, Suite 120

Torrance, CA 90505

office (310) 828-1414
fax (310) 347-4255
www.microtiaearsurgery.com

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