Otoplasty / Ear Surgery

Your GP or another specialist that knows you well must make a referral to Dr Avery. The decision to have a consultation may be made after talking with family or friends or following your own research into plastic surgery and Dr Avery.

The purpose of your initial consultation with Dr Avery is to discuss your motivations for surgery and expectations from surgery. It is an opportunity to openly communicate what you want to change, alleviate or remove. We will discuss any concerns you may have about your potential surgery and its outcome. We will also collect information that is specific and tailored to you, to add to the knowledge you acquired through your research outside of the consultation process.

When you arrive at Avery, you will check in with our Care Team and complete a medical history form, if not already completed. We encourage you to bring a supportive family member or friend who can remain with you throughout the consultation if you like, and be a sounding board during your decision-making process following the consultation.

The consultation with Dr Avery will include an examination of the area of your body that you are concerned with and considering changing. Our aim will be to determine if plastic surgery can achieve what you hope it will, and if so, what specific plastic surgery procedures will address your concerns and meet your expectations in a realistic way.

Plastic surgery procedures can impact physical appearance and there may be a psychological response to the changes in your body after surgery. Besides the reasons for having plastic surgery, it is important to be fully aware of any potential limitations of the operation and how they apply to your unique situation. This includes the risks of having surgery and all of the possible complications that can occur after surgery, and what can be done if these occur.

We will discuss what the surgery involves, how it relates to you specifically given your uniqueness and current state of health, what the possible risks of the surgery are, and then decide if having the surgery is a safe and appropriate choice for you as an individual.

Your consultation will also include a discussion of the estimated financial implications of having this surgery or surgeries that were discussed with Dr Avery.

After your consultation, our Care Team will be there to talk through any further questions you have, including the cost of the surgery.

At Avery, our goal is to ensure you are equipped with the knowledge needed for you to feel empowered throughout the decision-making process, surgery and post-surgery.

Ear correction surgery involves creating an incision behind the ear and removing a small amount of excess skin. The underlying cartilage, which gives the ear its structure and shape, is then moulded before closing the skin with sutures, placing the ear closer to the side of the head.

Reshaping the ear involves removing the skin and stitches are used to fold the cartilage back on itself to reshape the ear without removing cartilage. In most cases, ear surgery will leave a faint scar in the back of the ear that will fade with time. Even when there is only one ear that needs to be corrected, surgery is usually performed in both ears for better symmetry and a more natural appearance.

Ear correction surgery can take anywhere between 1–2 hours, depending on the complexity of the procedure and the patient is able to go home a few hours after the operation. Adult patients will need to organise somebody else to drive them home.

As with all surgical procedures, otoplasty surgery does have risks, despite the highest standards of practice. It is not usual for any surgeon to outline every possible side effect or rare complication of a surgical procedure. However, it is important that you have enough information about the most common risks to fully weigh up the benefits, risks, and limitations of surgery.

The following possible complications are listed to inform and not to alarm you. There may be other complications that are not listed. Smoking, obesity, and other significant medical problems will cause greater risk of complications.

Some general risks and possible complications of surgery include, but are not limited to the following:

• Heavy bleeding from an operated site. This may require a blood transfusion.
• Infection that may require treatment with antibiotics or further surgery in some cases.
• Allergic reaction to sutures, dressings or antiseptic solutions.
• The formation of a large blood clot (haematoma) beneath an incision site may require further surgery.
• Complications such as heart attack, pulmonary embolism or stroke may be caused by a blood clot, which can be life threatening.
• Pain, bruising and swelling around the operated site(s).
• Slow healing, often related to smoking or diabetes.
• Short-term nausea following general anaesthesia and other risks related to anaesthesia.
• Tissue cannot heal without scarring and that how one scars is dependent on individual genetic characteristics. Dr Avery will do his best to minimise scarring but cannot control its ultimate appearance.
• Smoking or using nicotine products during the 3–4-week pre-operative and post-operative periods is prohibited as these could dramatically increase the chances of complications.
• All medications I am currently taking, including prescriptions, over the counter remedies, herbal therapies and supplements, aspirin, and any other recreational drug or alcohol use can affect the safety of my surgery.
• There can be no guarantees about the results of any surgery.

Specific risks for otoplasty surgery include, but are not limited to the following:

Allergic reactions

• Scarring – Keloid scars are more likely on ears
• Asymmetry in healing or scarring
• Swelling
• Bleeding, haematoma
• Hearing change due to change in shape of ear canal
• Bruising
• Pain and discomfort
• Change in sensation of the ear
• Unsatisfactory result
• Revision surgery
• Further recovery time if further surgery is required
• Infection
• Temporary discomfort
• Recurrence (partial or complete)

The Australasian Society of Aesthetic Plastic Surgeons (ASAPS) has further information about otoplasty surgery including the possible risks for this surgery.

Most otoplasties can be performed as day surgical procedures. A soft bandage dressing is applied after the surgery and a quiet week is advised following surgery to help the recovery process and minimize discomfort and potential complications.

There will be some bruising and swelling, which generally subsides about 1 to 2 weeks after the surgery. After one week, the soft bandage is removed after and a stretchy head band is used for some time during the day to support and protect the ears as needed. A loose headband worn at night is also recommended for the first 6 weeks, to avoid the corrected ears from pulling forward while sleeping.

A customised pain relief program will be created for you and issued before you leave the hospital. If circumstances change at any stage during the recovery period, then the pain medication can be adjusted accordingly.

Scars from ear surgery are usually well-hidden behind the ears. They will generally fade to almost invisible, although this can vary depending on how well your skin copes with scarring.

The financial aspects of your surgery are as important as the medical elements when planning for surgery. At Avery, the surgeries we offer fall into three different financial categories: Self-funded – aesthetic surgery; self-funded – plastic and reconstructive surgery; and health insured – plastic and reconstructive surgery.

To make sense of these three financial categories, we have created a detailed price guide to help you understand what may or may not be covered by your health insurer/Medicare and your out of pocket expenses.

To download this guide, please click here.

For more information or to book a consultation, please contact our team on 02 4002 4150.

The post-op bandage needs to be kept dry while in use. After the first checkup, if the wound is healing well, the post-op bandage is removed and it will be acceptable to shower and wash your hair. Activities such as swimming can put pressure on the healing ears. Therefore, it is recommended to avoid swimming for 6 weeks. When returning to swimming lessons an adjustable neoprene (wet-suit material) headband can help gently support the ears and avoid the ears being pushed forward with the weight of the water.

As with all surgical procedures, revisional surgery may be necessary. This may be to correct minor irregularities or even some degree of recurrence of the initial concern. Surgery to the ear (or even simply ear piercing) can result in a keloid scar and this may need treatment. A keloid scar may not become obvious for several months following surgery.

Ear correction surgery is mostly done on children between the ages of four and fourteen because children’s auricular cartilages are still soft and it is easier to shape the cartilage or auricle into the appropriate form and pin it back, using gentle surgical techniques. Teenagers and adults have firmer cartilage; however, ear surgery can still be effective in teenagers and adults.

Where there are incisions, there are scars. As the incisions are usually located behind the ears, scars will be well-hidden. Ears can be an at-risk site on the body for keloid scars.

Some throbbing or aching of the ears may occur during the first few days. A customised pain relief program will be created for you or your child to manage pain and discomfort during the recovery period.

Pain following surgery will vary depending on the extent of surgery. Pain immediately after surgery may be reduced by the use of local anaesthetic at the surgical site given during the surgery. The pain will also be managed with tablets or injections as required. Physical measures such as the dressings and for some surgeries supportive garments, as well as limited movement and possibly ice packs will all help minimise any pain. Pain is usually well tolerated within a few days after surgery with all these measures. If your pain is increasing following surgery this is usually a sign that you may need a review to ensure your recovery is proceeding as expected.

Dressings and in some cases surgical garments will offer support to the wounds and the areas of your body that are still recovering. You will be also be advised to restrict excessive movement of the surgical area in the first two weeks after surgery. A good general rule throughout your recovery is if an increase in movement or activity does not increase any discomfort or swelling, then it is probably safe and this gradual progression back to ‘normal’ will be encouraged.

Typically, if your surgery is considered cosmetic in nature and does not have a related item number, private health insurance does not cover this surgery. If the surgery is being considered to address significant developmental differences, changes from previous trauma, or to relieve nasal obstruction, then a Medicare item number may apply to the surgery and there may be some cover of this procedure through private health insurance.

Sun exposure can adversely impact early wound healing and have an adverse effect on the pigmentation and long-term quality of you scar(s). All scars should be protected from sun until they are mature, which may not be until one-year post-surgery. A spray tan is okay after a few weeks (once the wound is healed).