Waiting for Brexton to wake up.

Brexton Hoffman Surgery Update

First post: Jun 24, 2017 Latest post: Jul 10, 2018
Brexton was born with a small, malformed or absent external ear on his left side. This condition is called Microtia. Microtia can also be associated with an absent or narrowed ear canal resulting in significantly decreased hearing.  In Brexton's case he does have some stenosis of the canal, but only mild hearing loss. Although, as his parents we beg to differ at times.😃  Microtia is seen on one side (unilateral) 90% of the time.  Only 10% of children born with microtia have the condition on both sides. Microtia is an uncommon condition, and the frequency of microtia in newborns varies in different countries. Only one in 8,000 to 10,000 children a year are born in United States with Microtia. This is exactly why Brexton LOVES to scratch off lotto tickets!

FIRST SURGERY IS SCHEDULED FOR JULY 10, 2017 @ 7am in San Antonio, Texas by Dr. Bonilla. Brexton has asked to have the reconstructive surgery.

Dr. Bonilla is the  only exclusive PEDIATRIC microtia surgeon in the United States and has performed thousands of surgeries to help children. He developed the Microtia-Congenital Ear Deformity Institute and is absolutely wonderful! 

Length of Surgery: Approx. 2 1/2 to 3 hours
Length of Hospital Stay: Discharged the following day


Brexton will have a Pediatric Epidural. The epidural is placed during the carving and sculpting of the ear. Brexton will be under anesthesia, so he will feel absolutely no pain. This will dramatically improve the post-operative discomfort so he will be pain free after surgery. 

Rib Harvest / Creation of Skin Pocket / Placement of New Ear Framework /
Applying Suction to New Ear

Harvest the Rib Cartilage:
A slightly oblique chest incision will be made over the 6th, 7th and 8th ribs close to the sternum (on the opposite side of his little ear). The  incision will be about 1 inch to 1 1/2 inches. The 6th and 7th ribs are usually fused together and will help form the base framework of the new ear. The 8th rib will be used to form the rim of the ear called the “helix”. Once the three pieces of rib are carved, sculpted and sutured together, the framework will be ready.

Creation of a Skin Pocket:
 An incision will be made in front of the microtic vestige. The upper part of the microtic vestige is usually made up of disorganized cartilage under the skin. This disorganized cartilage will be removed to allow more space for the insertion of the newly created cartilaginous framework.

Insertion of New Ear Framework into Skin Pocket:
Brexton will have a drain placed in the skin pocket to allow for suction of the skin over the cartilaginous framework. This cartilaginous framework will be ready to insert under the skin pocket and apply suction. He will get a fancy protective cup over the surgery site for protection.

- Admitted overnight. During the overnight stay,  we will have one-on-one nursing care. The nurses will educate us on drain management and give instructions concerning activities, etc…
- Brexton will be evaluated the next morning and sent to the hotel on antibiotics and pain medication to recover.
- The drain will stay in place for 7 days to provide negative suction so that the skin can adhere to the newly inserted cartilaginous framework.
- The sutures will be removed on July 17th and we will head home on the 18th.
- Contact sports restricted for 4 to 6 weeks.
- The next surgery is scheduled for August 31st

Second Surgery- August 31st
We fly into San antonio on Wednesday, August 30th and Brexton has surgery the following day. We are able to fly home on Friday.

Third Surgery- October 20th
After the outpatient surgery we must remain in Texas for 14 days. We will be home on November 5th. Brexton will be able to enjoy Texas and celebrate Halloween in the sunshine! 

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