Microtia Congenital Ear Institute
Surgery Instructions
These are Dr. Bonilla’s pre-operative and post-operative instructions for microtia surgery patients. Please read all sections that apply to your child’s upcoming stage and follow them carefully. Instructions may vary depending on the specific type of surgery being performed — if you have any questions, call the office before your appointment.
For existing patients of Dr. Arturo Bonilla · Not publicly listed
Medically reviewed by Arturo Bonilla, MD — August 2026
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Section 1 — Pre-Operative
Before All Surgeries
The following instructions apply before every stage of microtia surgery.
Please follow all of these regardless of which stage your child is undergoing.
No eating of solid foods 6 hours prior to surgery.
May drink sips of water 4 hours prior to surgery.
Do not take Aspirin or Ibuprofen 10 days prior to surgery.
May wash hair the night prior to surgery.
May brush teeth prior to surgery, but do not allow the child to swallow water.
Pharmacy preference: Please let us know your pharmacy preference so that we may call in medications the day prior to surgery.
Signs of illness: Please alert Dr. Bonilla of any signs of illness such as cough, cold symptoms, fever, etc., before the surgery date.
✏️ Editor note for Dr. Bonilla: This section applies to all stages. Update here to change pre-op instructions site-wide.
Section 2 — Post-Operative
After Stage 1
Instructions for the recovery period following the first stage of microtia reconstruction.
Overnight Stay
The child is watched overnight. During this overnight stay, there is one-on-one nursing care. The nurses educate the parents on drain management and give instructions concerning activities.
The child is evaluated the next morning and sent home on antibiotics and pain medication (if needed).
Ear Cup & Drain
Ear cup must be worn at all times until Dr. Bonilla evaluates your child in the office.
The drain stays in place for about 5 to 7 days to provide negative suction so that the skin can conform to the newly inserted cartilaginous framework.
Sutures are removed during the next surgery. No suture removal is needed at home.
Activity & Wound Care
Heavy activity is restricted for 4–5 weeks. No exercise or rough play. Contact sports are restricted for 4 to 5 weeks.
Dressing care during the 1st post-op week: No wound care is needed at home.
The incision on the chest area may be left alone until Dr. Bonilla examines in the office.
Hair may be washed a few weeks after surgery.
Stage 1 now creates the complete ear structure: framework placement, earlobe rotation, tragus formation, and conchal deepening are completed during this surgery.
⚠️ Watch For — Call Dr. Bonilla Immediately
If the ear becomes inflamed, turns red or purple, or if bleeding increases, please call Dr. Bonilla as soon as possible.
This is all extremely unlikely, but we provide these instructions to every family.
Also call for any redness, swelling, or fever.
Office: (210) 477-3277
✏️ Editor note for Dr. Bonilla: This section covers Stage 1 only. Activity timeline, drain duration, and chest incision note can be updated independently here.
Additional Earlobe, Tragus & Concha Care
These steps are now completed during Stage 1. Follow the Stage 1 recovery instructions above together with any additional directions provided by Dr. Bonilla.
Part of Stage 1: These structural steps no longer require a separate surgical visit.
Medications
💊 Antibiotic solution
💊 Steroid solution
💊 Pain medication (rarely needed)
Ear Cup & Sutures
Ear cup must be worn at all times until Dr. Bonilla evaluates your child in the office.
Sutures are removed during Stage 2 if needed. No suture removal is needed at home.
Activity & Wound Care
No wound care needed except observation at home.
The child can participate in activities as long as the ear cup is worn during activities.
Hair may be washed a few weeks after surgery.
Watch For — Contact Dr. Bonilla
Redness, swelling, or fever. All of these are extremely rare, but call the office if they occur.
Office: (210) 477-3277
✏️ Editor note for Dr. Bonilla: These additional instructions apply to the earlobe, tragus, and concha work now completed during Stage 1.
Section 3 — Post-Operative
After Stage 2
Instructions for the recovery period following the second and final stage of microtia reconstruction.
Same-day discharge: The child goes home the same day after Stage 2. No drains.
Medications
💊 Antibiotic solution
💊 Steroid solution
💊 Pain medication (rarely needed)
Ear Cup, Sponge & Sutures
Ear cup must be worn at all times until Dr. Bonilla evaluates your child in the office.
A sponge placed behind the ear is removed in approximately 5 to 7 days.
Sutures dissolve on their own. No suture removal needed.
Activity & Wound Care
No wound care needed except observation at home.
The child can participate in light activities as long as the ear cup is worn, starting after the 2nd week.
Hair may be washed a few weeks after surgery.
Watch For — Contact Dr. Bonilla
Redness, swelling, or fever. All of these are extremely rare, but call the office if they occur.
Office: (210) 477-3277
✏️ Editor note for Dr. Bonilla: This section covers Stage 2 (final) only. Sponge removal timing, activity window, and suture notes can be updated independently here.
Always call if you have a concern
No question is too small before or after surgery. Dr. Bonilla’s team is here to make sure your child’s recovery goes smoothly. If anything feels wrong, call the office right away — do not wait for the next appointment.