• Protruding ears (excessive cartilage)
• Large or deformed earlobes (including ‘lob ear’, where the tip of the ear bends down and forward)
• Tiny ears or ears without natural creases (‘cupped’ or ‘shelled’ ears)

• Most adults can have ear surgery and it’s usually for confidence and aesthetic reasons.
• In younger children, the procedure is usually performed to improve the appearance of the ears so that the child does not have to endure ridicule from peers throughout their childhood. The procedure can be performed on children aged between 4 to 14 as the ears are almost fully developed by the age of 4.

It’s important to note, children are not subject to any higher risks than adults and in fact, firmer cartilage of fully developed adult ears does not provide the same molding capacity as in children. Having the procedure at a young age is highly desirable for two reasons:

1. The cartilage is extremely pliable, thereby permitting greater ease of shaping.
2. The child will experience psychological benefits earlier from the cosmetic improvement.

Fig 1. Ear Surgery Incision. A patient guide - illustrations reprinted with permission of Australian Society of Plastic Surgeons Inc., The Australasian Society of Aesthetic Plastic Surgery and Mi-tec Medical Publishing. The complete pamphlet is available from your surgeon.

The procedure itself is straight forward and non-invasive, with incisions placed behind the ears so that there are no visible scars after the operation.

Techniques vary among surgeons and patients. Factors that may impact the choice of technique include the general anatomy of the ears, the extent of the ear cartilage, excessive skin in the surrounding area, or level of deformity in other areas of the ears.

There are two common Otoplasty techniques for protruding ears:

Dr Zacharia first determines the incision location by finding the most inconspicuous site on the back of the ear. Once the incision is made, Dr Zacharia will sculpt the exposed ear cartilage and re-position it closer to the head for a more natural-looking appearance.

1. In the second common technique, skin is removed and the ear cartilage is folded back. There is no cartilage removed in this technique.

The surgeon may use non removable stitches to help the cartilage maintain its position. Dissolvable or removable stitches can also be used for the incision location, which are removed or dissolve within seven days.

The operation is performed under a local anaesthetic or a light, general anaesthetic as a day procedure. Under normal conditions, time in surgery is about two hours.

For those instances where some of the natural folds are missing in the ear, they are created. Missing or abnormal sections of the ear may be constructed from tissues taken from other parts of the ear or body.

• In most cases the patients return home within hours of the procedure on the same day but in some general anaesthesia cases, an overnight hospital stay may be appropriate.
• Some bruising and swelling may occur.
• After the procedure, the head is wrapped in a thick pressure bandage, which you are required to wear for up to 10 days. Fitting of the bandage helps to maintain the new position of the ears and enhances the healing process.
• You usually return to Dr Zacharia’s office within the first few days to exchange the bandage for a lighter one or a headband. The nurses will fully explain how to use the headband and also provide a complete post-operative instruction list, which you should follow carefully to reduce the risk of complications.
• Young patients are often required to refrain from normal activity for at least seven days after surgery. Special care must be given to children throughout the first three weeks of recovery to restrict them from playful activities that may disrupt the ears.
• Adult patients usually return to normal activity within three days after surgery.

More complicated procedures may require a longer recovery time. In all cases, the ears should not be bent for at least a month or more.

While every care is taken to reduce post operative pain and complications, during recovery some Otoplasty patients may experience:

• Temporary discomfort and numbness, which can be managed through oral pain relief medications
• Headaches, which can be relieved through the use of a long-acting analgesia
• Swelling can be reduced with continued elevation of the head and usually decreases within a week
• Unusual sensations may include itching or lack of sensation at the incision line, which can disappear over the course of six months

Any type of surgery involves the potential for complications and risk. Dr Zacharia takes all precautions to minimise complications and risk but some patients may suffer from bleeding, infection, haematoma, cauliflower ear, numbness, scar tissue/Keloid formation, asymmetry, loss of result requiring further surgery, over-correction, under-correction or a poor aesthetic result. Approximately 5% of patients require further minor correctional surgery.

It’s important to discuss any concerns you have with Dr Zacharia but, remember, there is no need for you or your child to feel self conscious about your ears or put up with bullying or ridicule.