Ear reduction and set back of prominent ears can often be performed under local anaesthetic as either an Out-Patient (walk-in, walk-out) case or as a day case. All patients who elect to have aesthetic ear surgery under general anaesthetic need to stay in hospital at least for the day of surgery, but not usually the night.
Ear reconstruction patients whose ears are rebuilt from cartilage taken from the chest stay in hospital for four to five nights after the first stage. Initially a small drain coming from the chest incision drains away any fluid that might otherwise accumulate. This drain is often used to give pain-killing medication directly into the chest wound. Tiny drains which come from the site of the new ear suck the skin of the new ear onto the cartilage framework.
After any operation, it is beneficial to elevate the affected part. This reduces swelling and discomfort and speeds healing. After any ear surgery, it is helpful to sleep with extra pillows for at least five days rather than lying flat, and ear reconstruction patients are usually nursed in a sitting position for five days.
To achieve the best possible result after surgery, it is important that sutures (stitches) and, later, scars are given proper care. If you wish to take pain relieving tablets after leaving hospital, paracetamol (Panadol) are best. Avoid aspirin, or aspirin-containing compound preparations, since these tend to cause bleeding. Medications containing non-steroidal anti-inflammatory ingredients (like Nurofen, Brufen, Ibuprofen, Ibuleve etc) can do the same.
Wounds may be sutured in a variety of ways. Non-dissolving stitches must be removed. The timing of suture removal is variable and depends on the type of operation. Head bandages normally stay on, and stitches stay in, for 5-7 days after ear reconstruction, set back of prominent (sticking out) ears and reduction of large ears. Dressings and bandages after ear lobe surgery are often minimal. Overseas patients having aesthetic ear surgery may wish to have their sutures removed in their home country, but it is preferred that ear reconstruction patients remain in the country at least until their sutures are removed, and particularly after first stage ear reconstruction surgery.
Please try to avoid clothing which pulls over the head in the first few weeks of surgery. You can return to work or to school the day after ear reduction, set back of ears or other aesthetic ear surgery. Ear reconstruction patients can return once to work or school after stitches are removed, but should avoid contact sports or very vigorous activity for three months.
Dissolving stitches may be left beneath the skin to provide support; occasionally your body does not dissolve them and instead extrudes them, so that they appear just beneath or through the wound, often several months after surgery.
Please keep your wound dry until you have been seen for review and your stitches removed. If a crust builds up around the stitches, it can be removed with a cotton bud dipped in warm water and, after washing, you should apply a fine smear of antiseptic ointment over the wound (usually Chloramphenicol “eye” ointment).
When you are able to begin washing the area again, do so gently with soap and water and pat dry with a clean towel. Do not pull at the wound or soak it as this may cause it to stretch. Should your wound become inflamed or tender, you should contact us immediately.
When the stitches are out and the wound soundly healed (around the fourth post-operative week), the scar should be massaged with a little Nivea cream twice each day for three months. Massage should begin gently over ten minute periods several times per day; later, more firm massage can be given. This will soften the scar and help it to fade more quickly. Special silicone oil preparations such as Dermatix (available direct from the office) are even more effective. It is wise not to expose new scars to sunshine.
Most scars take three months to reach 80% of their full strength and for this period they are often active, red and a little raised. After this they fade and flatten: this full maturation process usually takes twelve to eighteen months but varies according to individual skin types. Those with red hair and fair skin tend to develop scars which stay redder longer than those with a darker complexion. Try not to scratch your scar as it may stretch. If itching is a problem, Eurax ointment may help.