Unfortunately, this is not a straightforward answer.
Otoplasty is most often a cosmetic, elective operation. Thus, it is typically not covered by insurance.
However, there are instances when insurance companies may pay for the procedure based on its reasoning.
Unfortunately, there are no fixed rules for what determines if an otoplasty is covered by insurance or not, and it is ultimately up to the individual insurance company whether it covers the procedure.
But there are plenty of instances where the procedure is covered by insurance.
One example of when the surgery is covered by insurance is prominauris — an abnormal projection of the ear from the mastoid cortex — which may be determined to be a congenital deformity. This could also lead to an insurance-covered procedure when it’s considered a functional operation (due to symptoms of pain or other medical issues) by insurance companies.
These scenarios are more likely to occur in younger children than adults.
It is important to note that a facial plastic surgeon does not have the ability to have a procedure covered by insurance, as it is ultimately up to the insurance company to make that decision.
What is Otoplasty?
Otoplasty, sometimes called “ear pinning,” is a common procedure performed by experienced facial plastic surgeons, and one that is done regularly at The Williams Center.
This is a cosmetic procedure designed to alter the size, position, and/or shape of the ear.
Often, it is performed because a patient wishes to lessen the look of prominent ears.
There are several causes of prominent ears or prominauris. The most common causes are a poorly formed anti-helical fold, poorly developed conchal bowl, or, oftentimes, a combination of both.
What Are an Otoplasty Procedure & its Recovery Like?
An otoplasty procedure is customized to the individual and involves altering the shape and position of the ears to improve appearance and symmetry.
Prior to the operation, you will meet with your facial plastic surgeon to discuss expectations and desired results.
The surgery itself takes about two hours to complete, with one hour focusing on each side, and it is performed under general anesthesia in an operating room.
During the procedure, excess skin and cartilage may be removed through an incision behind the ear. The ear is then reshaped into the desired position using suture techniques. This is an outpatient surgery, and you can go home the same day.
Following the operation, a tight ear dressing is placed while you are still asleep, and this will stay on for anywhere from one to three days.
After that time, we recommend wearing a compression headband over the ears as much as tolerated for the next couple of weeks and wearing it any time you are sleeping to prevent inadvertent damage to the repair.
You can expect to have some swelling and bruising after the procedure, but this usually does not last long. Most people see immediate results when the first dressing is removed one to three days after surgery.
If you want to view an otoplasty procedure, watch a video of the one being performed here at The Williams Center.
Will I Have Scarring From the Procedure?
All the incisions of an otoplasty are made behind the ear and are therefore hidden and exceedingly difficult to see.
As healing occurs, the scar essentially disappears and is difficult to even find a year later.
At What Age is Otoplasty Preformed?
The short answer is: Any age.
However, the most common age for an otoplasty is around 4 to 5 years of age, when the ear is about 90% of its adult size.
This young age also allows the procedure to be performed before children enter school and start to develop a body image.
Watch a case study of one of our patients who was tired of getting picked on for his ears and how our team helped him with an otoplasty.
However, otoplasty can be performed at any age after 5 years old, including in adulthood.
How Much Does Otoplasty Cost if It Is Not Covered by Insurance?
Most commonly, otoplasty is not covered by insurance as it is considered an elective procedure.
If it is not covered by insurance, the cost depends on several factors, including the procedure itself, geographic area, and experience of the surgeon.
And, since the procedure is performed under general anesthesia in a surgery center, patients can expect additional facility and anesthesia fees.
At The Williams Center, we are experienced with the otoplasty procedure and would love to meet with potential patients to further discuss the operation.
Please give us a call at 1-800-742-2797 or schedule a consultation online if you are interested in pursuing a otoplasty procedure or discussing payment options.
About the Author: Dr. Edwin Williams
Dr. Edwin Williams is a double board-certified facial plastic surgeon who founded The Williams Center in 1993. He has performed over 10,000 facial plastic surgery procedures and has pioneered the deep plane facelift. He served on the Board of Directors for the American Academy of Facial Plastic Surgery for over a decade, and served as President from 2015-2016. In 2016, 2017, 2018 and 2019, Dr. Williams earned the Castle Connelly Top Doctors award in New York Facial Plastic Surgery.
Dr. Edwin F. Williams III attended Cornell University in Ithaca, New York where he received a Bachelor of Science degree in 1982. He began medical school at the State University of Buffalo School of Medicine and received his Doctor of Medicine in 1986.
Dr. Williams is actively involved in teaching facial plastic and reconstruction surgery to the residents of the Albany Medical Center and is former Chief of the Section of Facial and Plastic Reconstruction Surgery at Albany Medical Center where he received an academic appointment of Clinical Professor, Department of Surgery.