An incision is made behind the ear in the natural crease where the ear and head join. The skin is loosened from the cartilage of the ear. The cartilage is often reshaped with stitches to give a more natural look to the ear. I tend to avoid placing cuts in the ear cartilage, as I think this results in an unnatural shape. In fact, I have published an instructional article on my otoplasty techniques in a national surgical journal. This article can be made available to patients, although it is intended for a medical audience.

To fully understand the costs of cosmetic surgery, you must understand the guiding principles of my medical practice: Safety, Quality and a Respect for Cost. I have not designed the surgical experience to be lowest bid; rather, I want you to have an exceptionally high-quality medical experience. If this interests you, please read on.

There are three main components that contribute to your final cosmetic surgery fee. The first component is the surgeon's fee. As this is a medical experience, your final surgeon's fee can only determined after a full consultation with me. I will perform a complete history and physical exam and we will carefully discuss your concerns. Computerized imaging is often used to help better plan your surgery. As a reference point, a recent survey of the American Academy of Facial Plastic and Reconstructive Surgery showed the average fee of otoplasty to be $3114.

The second cost component is the facility in which your operation is performed. I operate only in a state of the art surgical enter - not in a in-office surgical room. This surgical center is JCAHO certified, which means it has passed the highest level of federal inspection. Cosmetic surgery is real surgery, and I strongly believe that having it performed in a JCAHO certified center is in your best medical interest. The average surgical center fee for this operation is $1085.

The final cost component is the anesthesia fee. The training background of the person ultimately responsible for your sedation should be carefully considered. Nurse anesthetists are members of the surgical team; however, in every cosmetic operation I perform, an anesthesiologist who has completed medical school, residency, and board certification is responsible for your sedation. This is the level of care I would insist on for my own family members. Anesthesia fees for this operation average $530.

After your consultation you will leave the office with an easy to understand written quote in which we will list the cost of these three components for your individualized surgical plan. Keep in mind that the facility and anesthesia fees are time-based and so may be increased, or decreased, based on the actual final length of your surgery.

Dr. Mobley wants to make cosmetic surgery available to as many people as possible. For that reason we have hand picked lending services exclusively for Dr. Mobley's patients. When you come in for your consultation we will be more than happy to go over all your financial options with you. We have provided web links to our financial lenders so that you may research them on your own if you so desire. www.mlendfinancial.com

For one week following the operation, you will wear a protective dressing over your ear(s) to protect the delicate stitches placed during the operation. After one week, I will see you back in the office and remove any stitches that were placed. I encourage my patients to purchase a sports headband and to wear this around the ears at night and while sleeping for four to six weeks following surgery.

In some situations, particularly for young children, insurance companies may view otoplasty as covered under your policy. Our staff can help you determine this before surgery. If not covered by your insurance carrier, payments can be made prior to surgery.

• Mobley SR, Vartanian JA, Toriumi DM. (2002). Otoplasty. Operat Tech Otolaryngol Head Neck Surg, 13(1), 29-35.

• Mobley SR, editor. (2006) Auricular Surgery: Aesthetic and Reconstructive. Facial Plastics Surgery Clinics of North America. Elsevier Health Sciences publisher, Philadelphia, 14(2).

• Nuara MJ, Mobley SR. (2006). Nuances of otoplasty: a comprehensive review of the past 20 years. Facial Plast Surg Clin North Am, 14(2), 89-102, vi.