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World's Only Exclusive Pediatric Microtia Surgeon · San Antonio, TX (210) 477-3277
Patient Guide

Surgery Instructions

These instructions are provided to help families prepare for surgery and understand the recovery process following each stage of reconstruction.

Dr. Bonilla and his team will review specific instructions with your family, but this page gives parents a calm, organized reference before surgery and during recovery at home.

Instructions Before Surgery

  • No eating of solid foods 6 hours prior to surgery.
  • May drink sips of water up to 4 hours prior to surgery.
  • Do not take Aspirin or Ibuprofen for 10 days prior to surgery.
  • Hair may be washed the night before surgery.
  • Teeth may be brushed before surgery, but do not swallow water.
  • Please let us know your preferred pharmacy so medications may be called in the day before surgery.
  • Please notify Dr. Bonilla if your child develops any signs of illness, including cough, fever, cold symptoms, or other concerns before surgery.

Recovery After Surgery

Recovery instructions vary by stage. The most important points are to protect the reconstructed ear, observe your child closely, and contact Dr. Bonilla’s office with any concern.

After the 1st Stage

  • The child is observed overnight with one-on-one nursing care.
  • Nurses educate parents on drain management and post-operative care.
  • The child usually goes home the following morning with antibiotics and pain medication if needed.
  • The protective ear cup should be worn at all times until Dr. Bonilla evaluates your child.
  • The drain remains in place approximately 5–7 days to provide negative suction so the skin can adhere to the new cartilage framework.
  • Sutures are removed during the next surgical stage.
  • Heavy activity, rough play, and contact sports should be avoided for approximately 4–5 weeks.
  • During the first postoperative week, no wound care is necessary.
  • The chest incision should be left alone until examined by Dr. Bonilla.
  • Hair may be washed a few weeks after surgery.
  • Please contact Dr. Bonilla’s office immediately with redness, swelling, fever, or other concerns.
  • Office: (210) 477-3277
  • The next stage may proceed approximately two months later.
What to Watch For

If the ear becomes inflamed, turns red or purple, or if bleeding increases, please contact Dr. Bonilla immediately. These complications are extremely uncommon, but every family receives these instructions.

After the Ear Separation Stage
(if needed)

  • The child returns home the same day.
  • No drains are required.
  • Medications typically include an antibiotic solution, steroid solution, and pain medication (rarely needed).
  • The protective ear cup should be worn continuously until Dr. Bonilla’s follow-up evaluation.
  • The sponge behind the ear is removed after approximately 7 days.
  • Sutures dissolve on their own.
  • No wound care is required other than routine observation.
  • Light activity may resume after approximately two weeks while continuing to wear the ear cup.
  • Hair may be washed a few weeks after surgery.
  • Please contact Dr. Bonilla’s office with redness, swelling, fever, or any concerns.
  • Office: (210) 477-3277
What to Watch For

Redness, swelling, or fever. These complications are extremely rare, but please notify Dr. Bonilla immediately if they occur.