THE PROCESS OF PLANNING YOUR SURGERY 
During your initial consultation, a thorough medical history, including smoking habits, previous surgery, regular medications (including blood thinners), previous history of deep venous thrombosis, diabetes, stability of weight over time and all other relevant details will be noted. Dr Farhadieh will discuss the areas of concern with you. Prominent ears that stick out from the head, asymmetries in appearance of the ears, absence of ear folds and/or earlobe prominence are common complaints. Dr Farhadieh will go through the surgical options with you and preoperative photographs will be taken. Smokers will be requested to cease smoking for 3–6 weeks prior to surgery and to abstain for at least 3–6 weeks after surgery.
On the day of surgery you will be seen by our anaesthetist who will discuss the anaesthetic procedure with you. Dr Farhadieh will meet you to answer any final questions. You will be brought to the operating theatre, where the surgery is performed under general anaesthetic.
WHAT TO EXPECT AFTER YOUR SURGERY 
The surgery will take about 1–2 hours. Local anaesthetic infiltration into the surgical field will address pain control over the first few hours. Afterwards, simple oral pain relief suffices. Incisions are hidden behind your ear and the cartilage is moulded into the aesthetically correct position and the earlobe corrected if required. After the surgery you will have a head bandage for 5–7 days.
Your postoperative follow-up is organized for 5–7 days postoperatively and your sutures will be removed. You can resume work at this time. Physical activities, including those that may cause trauma to the ear, should be avoided for at least 8 weeks postoperatively.
Although this is considered relatively routine and safe surgery there are risks associated with any surgical procedure. These include infection, asymmetry, scarring and cartilage damage. Dr Farhadieh will discuss these with you in detail during your consultation.
Your relationship with your surgeon is the most important element of your care. Dr Farhadieh and his staff are dedicated to being there for every step of your journey.
Frequently Asked Questions
Yes, you will require general anaesthetic for the surgery. Local anaesthetic infiltrate at the time of surgery will keep the area well anaesthetized during the immediate postoperative period.
The scars are hidden from view in the crease behind the ear and are generally not noticeable.
Once the wounds have healed in 7–10 days, normal activities can recommence. However the ears should be protected against any direct trauma for at least 12 weeks. Individual recovery varies between individuals.
All humans have some intrinsic asymmetry to their face and body, but noticeable persistent postoperative asymmetry is rare. The position of the upper poles, the middle part and the lobule of the ear against the head ultimately determine their relative appearance. Establishment of relative harmony and symmetry determines the final outcome.
Dr Farhadieh believes that the relationship between doctor and patient is sacred and privileged. Our practice is based on compassion, honesty, transparency and, above all, patient welfare and we pride ourselves on making sure that our patients feel supported at all times. We will be available during all stages of your journey and will schedule short-, medium- and long-term follow-up appointments as part of our overall practice.
1. There are some general risks associated with ANY operation, which include:
a) Infection in surgical wound(s) with resultant redness, pain and possible discharge. In severe cases, wound(s) could break open and need to be washed out and debrided prior to being closed again.
b) Possible bleeding in surgical wound(s) with swelling or bruising.
c) Secretions may accumulate in the lungs and cause a chest infection.
d) Deep vein thrombosis (DVT).
e) Death is possible during or after an operation following severe complications.
f) Smoking significantly increases the risk of complications. Therefore, you should completely stop smoking at least 4 weeks prior to surgery, and refrain from smoking for at least 4 weeks.
2. The following facts, risks and complications apply specifically to THIS operation:
a) Antibiotics are given during and after the operation, to minimise the risk of infection. If infection were to occur, it would be treated with the usual techniques.
b) Bruising, swelling, and numbness of the ears, are expected for two to six weeks and may last longer. Some swelling of the ears may persist for several months.
c) Postoperative pain experienced varies from very mild discomfort to significant pain. You will be given analgesic medication following your surgery and this should keep you comfortable.
d) There will be a scar associated with this procedure. The location and extent of this scar will be explained to you. In rare cases, hypertrophic scars that are red, raised and thickened may form over the healed incisions. These may be itchy, annoying and unsightly but are not a threat to health. A component of this is related to body’s intrinsic scar formation mechanism and is unrelated to the surgical technique.
e) It is possible, though unusual, to experience a bleeding episode during or after surgery. Should postoperative bleeding occur, it may require emergency treatment to drain accumulated blood or a blood transfusion. The risk of increased bruising or bleeding can be reduced by abstaining from medications such as aspirin, anti-inflammatory drugs, or other blood thinning agents, for at least 2 weeks prior to surgery (See Pre-Op Medication Info sheet).
f) Specific to this procedure there is a risk of cartilage infection, which if left untreated can lead to destruction of the cartilaginous framework.
g) In rare cases the sutures may rupture, hence a recurrence is possible. Dr Farhadieh rarely uses permanent cartilage scoring techniques, which are considered risky by most experienced ear surgeons.
h) No guarantee can be given in relation to size, shape, symmetry or character of the ears following surgery. Occasionally, additional surgery is necessary to correct minor irregularities.
i) Most patients will need to take at least one week off from work. Heavy lifting, vigorous exercise or any activity that increases blood pressure should be avoided for at least 4-6 weeks from surgery. See Pre and Postoperative Instructions for more details.
j) It is possible, though unusual (<2%), to experience a bleeding episode during or immediately after surgery. Should postoperative bleeding occur, it may require emergency treatment and surgery to drain accumulated blood, and/or a blood transfusion. I will not take any Aspirin or anti-inflammatory medications for ten days before and after surgery, as this may increase the risk of bleeding.
k) Infection is unusual after this type of surgery. Should an infection occur, treatment including antibiotics or additional surgery may be necessary. Rarely this may result in infection of the ear cartilage resulting permanent damage to the shape of the ear.
l) Keloid or hypertrophic scarring may occur and may be permanent
m) You may not be satisfied with the final aesthetic outcome.
The aim of otoplasty surgery is improvement rather than perfection. Further operations may occasionally be required to improve the results.
