YOUR JOURNEY FROM CONSULT TO SURGERY

 

It is mandatory to have a GP referral to see Dr Somia. Two consultations are required by law before a date for surgery is scheduled (one can be a virtual consult). Body Dysmorphic Disorder (BDD) screening questionnaire is required by law.       

 

The 'cooling off' period between the two consultations is designed to allow you plenty of time to consider your decision and feel comfortable about the procedure.   Once you confirm your decision to proceed with surgery, we will assist and prepare you for your surgery (ie paperwork and information, pre-operative testing as appropriate). 

 

During the consultation we will discuss your specific goals followed by a formal examination and thorough anatomical assessment of the ears to identify the key anatomic causes of the prominent ear.

 

The three key elements that result in a prominent ear are:

 

1) Lack of development of the antihelical fold,

2) prominent conchal bowl due to excess cartilage resulting in the prominence and

3) an outward pointing ear lobe.

 

I will proceed to ask you questions regarding your health to ensure it is safe to proceed with surgery. I will then photograph your ears. These photographs serve as medical records and help in planning the surgery. At the end of the consultation I will present a customised surgical plan appropriate and effective to address your concerns and achieve your aesthetic goals. Adequate procedural and financial information will be provided to enable you to make an informed choice whether to proceed with surgery or not. 

 

COST OF SURGERY

 

If you choose to have Prominent Ear correction surgery as a private patient you will have 'out of pocket expenses'. After the consultation, we will give you the necessary financial information including a cost breakdown and the out of pocket expenses associated with your surgery. 6 months of after care is included.

 

PROCEDURE DETAILS 

 

The surgery is performed in a facility licensed for cosmetic surgery and takes approximately  2 hours. It  is done under a General Anaesthesia to ensure you are comfortable and the Specialist Anaesthetist will ensure your safety and comfort during the operation.

 

Before the skin incision is made I inject long acting local anaesthetic all around the ear for long lasting pain relief. I will then make an incision in the skin behind the ear to access the cartilage.

 

Anatomic specific correction of the prominent ear is then undertaken including: 

 

1) The lack of development of the antihelical fold is addressed by recreating the fold,

 

2) The prominent conchal bowl due to excess cartilage resulting in the prominence is addressed by removal of excess cartilage and repositioning the conchal bulge closer to the head and

 

3) the outward pointing ear lobe is repositioned to bring 'in' the ear lobe.

 

Once the desired shape and position of the ear are achieved, cartilage stitches are used to hold the new position. The incisions are meticulously closed with fine dissolving sutures in multiple layers to ensure good healing, wound strength and a favourable scar. If both ears need correction, they are usually operated on during the same session. Sterile dressings and a soft "turban" bandage will be applied.

 

You may go home the same day or stay overnight for monitoring and pain relief. You will be discharged home with pain medications, antibiotics and care instructions. 

 

POST OP CARE OF THE SUTURE LINE

 

The first post op visit is 5-7 days following the operation. The head bandage will be removed, the position of the ear and the wound is examined for infection. Expect to see some residual bruising and swelling in the ears. The ears will be cleaned with sterile saline solution and an antibiotic ointment will applied to the suture line. You will be instructed to apply the ointment to the suture line 2-3 times a day for a week.

 

You may shower, but must take care to "pat dry" or blow dry the back of the ear to ensure excess moisture does not collect in that space. Excess moisture will impact healing and scarring. Swimming or immersing your head underwater is permitted after 3 weeks.

 

SCAR MANAGEMENT

 

Scar management is an essential part of the after care that I provide my patients. Designing the location of the scar, meticulous tissue handling during surgery, sterile techniques, layered suturing for better healing and choice of sutures are important factors that influence the quality of the scar.

 

In addition, I have found that silicone scar therapy and sun protection in the first 3 months is equally important. You will be instructed to apply silicone scar gel to the suture line twice a day for 3 months and avoid direct sun exposure. There is no harm in continuing the scar management after 3 months. 

 

RECOVERY AND TIME OFF WORK

 

I have found that every patient recovers differently influenced by their general health, diet, age, genetic makeup and presence of other medical conditions. 

 

Initial recovery is approximately 1-2 weeks.   A return to normal activities can usually be expected after 4 weeks. The results are visible soon after the operation but allow 3 months for the healing process to be complete.  A soft head band (like a tennis band) needs to be worn at night for 6 weeks  to protect the ears and  prevent accidental folding while turning in your sleep. 

 

You can return to work when you feel well.    Most patients take 1- 2 weeks off work if they work indoors. 

 

Patients working outdoors or in a physical capacity where the ear is at risk may need to take up to 4 weeks off work whilst they recover.   Talk to us about your specific occupation and surgery.   

 

You can drive after 24 hours, when the anaesthetic has worn off, your vision is clear, and you are pain free getting in and out of your car.   You should check your vehicle insurance policy for their requirements in this situation.  

 

RISKS OF PROMINENT EAR CORRECTION SURGERY

 

Prominent ear correction by otoplasty or ear pinning surgery is considered  safe and the risks are low when the 5 Pillars of Surgical safety are adhered to.

 

The 5 pillars of surgical safety are:

 

1) Surgery performed by a Specialist Surgeon

 

2) anaesthesia performed by a specialist anaesthetist

 

3) surgery performed in a facility licensed for cosmetic surgery

 

4) Surgeon is able to provide after care and

 

5) Surgeon is able to admit patient to the hospital in the event of an emergency.

 

Generally speaking all invasive surgery carries risks similar to air travel risks. When travelling on a plane  the expectation is a safe journey and arrival, it is understood and accepted that things could go wrong. The choice of the airline based on safety record, competency of the Pilot and and flight path are important elements in determining risk. Similarly, for your surgery, the experience and expertise of your Surgeon, the skill of your anaesthetist and the standard of the hospital will determine the risk. Risks, both general and specific, will be discussed during your consultations and written information will be provided to help you make an informed choice.    

 

General risks include pneumonia, deep venous thrombosis and pulmonary embolism, stroke, heart attack, allergies, awareness, death, bleeding, infection, sensation change, haematoma and seroma, skin contour irregularities, damage to deeper structures, Firmness, delayed healing and tissue death, exposed sutures, dog ears or additional skin folds, dressing issues, asymmetry, scars and unsatisfactory results. 

 

Risks specific to Otoplasty

 

Injury to the ear cartilage , infection at the surgical site, unfavourable scarring (though this is rare), asymmetry or dissatisfaction with the results, temporary numbness or tingling in the ears.

 

 

Our practice privacy policy prevents sharing patient before and afters online. However, during your consultation you will be shown numerous before and after photos.     

 

ABOUT  DR NAVEEN SOMIA PhD, FRACS