Otoplasty on children is always done with a general anesthesia. By the time their ears are developed enough to undergo the procedure their anesthetic risk is very low.
Adults have a choice between local and general anesthesia, or what is called monitored-anesthetic-care, in which the patient is sedated by an anesthesiologist but given local anesthesia.
Some patients simply want to go to sleep and not think about it. Others want to stay awake, and Dr. Teitelbaum is expert at gently providing the nerve blocks that can quickly make the ear numb. So in either case the surgery can be done with comfort.