To learn more about surgery, including cost, please fill out our online form: Contact Us

We accept most U.S. based insurance policies. We are considered out-of-network with all insurance providers, but the majority of our patients get an exception from their insurance to see Dr. Lewin as “in-network” and then only have to pay their in-network responsibility. We have partnered with a Patient Advocacy group to help families navigate the insurance process.

We do not accept international insurance policies. International patients would need to pay for surgery before it can be scheduled , and submit for reimbursement on their own. We can provide international patients with documentation needed to assist them with reimbursement.

U.S. patients must stay in California for 2 weeks after the 1st stage PIER surgery, whereas international patients must stay in California for 3 weeks after surgery. If a patient needs a 2nd stage surgery, the typical stay in California is 5-9 days.

The PIER technique can be done as young as 5 years old, and any age thereafter, including adulthood.  If the patient has grade 4 microtia (antotia) the minimum surgical age is 7 years. While there are many advantages to performing surgery at a young age, it is important to take into consideration timing for the best possible outcome and safety.

For a child with unilateral microtia, typically only 1 surgery is required. A 2nd revision surgery may be recommended for some patients, particularly those with more difficult anatomy (such as those with syndromes or hemifacial microsomia). The 2nd surgery can be performed approximately 6 months after the 1st surgery. In a bilateral child, 2 surgeries will be required 3 months apart, but sometimes a 3rd surgery is performed to improve the outcome.

The newly reconstructed ear will be swollen and purple/red for the first few weeks and will become less swollen and more defined with each week. While the healing process is different for each patient, it typically takes about 6 months for the ear to be almost fully healed. Watch a patient’s Lewin Ear Implant heal over 6 months:

Most surgeries take place at Cove Surgery Center, a new outpatient surgery center located next door to our clinic in Torrance, California. No overnight hospital stay is required. Cove Surgery Center was built to the highest standards of operating room facilities and is certified by Medicare and AAAHC.

The anesthesiologists at this surgery center have worked with Dr. Lewin on microtia cases for over a decade; they provide an excellent and extremely safe experience for her patients. There are NO nurse anesthetists or anesthesia residents (doctors intraining). If a 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 a local hospital.

To start the process, please fill out our online form at: Contact Us.

Our office will provide you with the specific steps needed in order to schedule a consultation with Dr. Lewin either by Zoom or in-person if living in the Southern California area.

This is a common myth. No, the body cannot reject the implant. The implant is made from a synthetic material (porous polyethylene) that is designed to allow the body’s tissue to grow into the tiny pores of the implant. So, even though it is a foreign material, the body’s tissues integrate into the implant instead of building a wall around it the way most implants are walled off (like silicone). Further, the body can’t “reject” something that is not living tissue, the way a kidney transplant can be rejected, for example.

Yes, but Dr. Lewin has greatly reduced this risk with her innovative one-piece “Lewin Ear Implant” and “3D Lewin Ear Implant” by Su-Por. These implants are much stronger and should not fracture.  The older 2-piece Medpor and Su-Por implants are more likely to fracture.

If a fracture occurs, surgery is required to replace the implant. 

The average length of the 1st stage PIER surgery is 8 hours, but it can be shorter or longer depending on the complexity of the anatomy. If a 2nd stage PIER surgery is recommended, it is typically 2-6 hours, but it varies depending on the scope of the surgery and if operating on one or both previously reconstructed ears.

Like any surgery, there are several possible complications with PIER surgery. Fortunately, the incidence of these complications is very low in Dr. Lewin’s practice. Risks of PIER include: an exposure (or hole), infection, implant fracture, bleeding, and temporary (or rarely permanent) injury to the nerve that raises your eyebrow. Click here to see Dr. Lewin’s complication rates.