Facial Surgery


Why have an Otoplasty?

The aim of an Otoplasty, or ear reshaping, is to improve the shape and contour of the ears.

Success should not be judged by the amount removed, but uniquely by the new shape achieved. People seek ear reshaping to correct a perceived imperfection.

An Otoplasty can be carried out from any age as by the age of six the ears have reached approximately 90% of their adult size.

What is involved?

During your consultation I will try to determine the changes that you wish to make to your ears.

An Otoplasty could provide significant enhancement to the appearance of the ears for both men and women and is performed under general anaesthetic and will require an overnight stay in hospital.

We can decide the shape of your new ears together, but Many considerations need to be taken into account and these will be discussed during your consultation.

After an Otoplasty is completed, you will have a dressing put on in the operating theatre. The most important is for the patient

I perform otoplasty by making the incision behind the ear so in most cases the scar will be hidden.

Otoplasty Aftercare

After surgery

After surgery is completed, a head bandage is placed on in the operating theatre. It is important that this is used for a period of at least 30 days.

The next morning the pain will inevitably have eased considerably. Any remaining discomfort can be controlled by medication.

A Otoplasty requires an over-night stay at the hospital so your immediate recovery can be closely monitored by a member of our medical team.

Your recovery

Recovery depends greatly on the extent of the procedure. Expect to feel sore and swollen for several weeks.

Strenuous activity should be avoided for 4-6 weeks. Although most of the bruising and swelling usually disappears within three weeks, some patients may experience swelling for longer.

Post-operative appointments

Post-operative follow-up is of paramount importance. Each patient undergoing Face Lifting surgery will be given post operative appointments for wound management and suture removal. Post-operative instructions are vital and we consider it very important that you adhere to them. Failing to follow these guidelines and attend your appointments can adversely affect the outcome of surgery and put patient safety at risk. Following Face Lifting the patient is asked to return on specified appointments fixed by me. Occasionally it may be necessary to return more regularly than those stated.

Otoplasty Risks and Conditions


Smoking reduces the blood supply to the wound and can impede the healing process. Each cigarette further constricts acutely the blood vessels. It is highly recommended to stop smoking completely 4 weeks prior to surgery and 2 weeks after; no nicotine patches or chewing gum are allowed. The risk of infection and complications in general slowly decreases if the patient stops smoking, but still remains higher compared to a non-smoker.


I perform otoplasty by making an incision behind the ear. In most cases the scar will be hidden. Occasionally the scars on either sides may not heal at the same rate. A minority of patients may require scar revision under local anaesthetic several months following surgery.

Haematoma (bleeding)

A haematoma is a collection of blood. The risk is higher during the first 24 hours following any surgical procedure, but it can still occur at a later stage. In case of a major collection of blood it may be necessary for patients to return to theatre for a second operation to remove this collection, although extremely rare. The risk of bleeding slowly fades in 3-4 weeks as the healing continues. We recommend that you refrain from any heavy lifting and strenuous activity during this period.

Swelling and bruising

Some swelling and bruising will be present after surgery. Usually this subsides in a few weeks, but can last some months post-operatively.


All surgery carries the risk of infection. In order to reduce it, patients are given antibiotics intravenously during the operation.


Most patients will experience pain following surgery, this certainly depends on the pain threshold of the patient. Painkillers are given after the surgery to control the discomfort, a further supply is dispensed at the time of your discharge. It has been reported that pain may appear during this period and can become permanent, although this is a rare occurrence.


It is known that the ear cartilage has a “memory” and in a small percentage of patients it folds back. If that is the case we have to wait 1 year before performing revision surgery.

Risk and Preparations for General Anaesthetic Procedures

What is involved?

A general anaesthetic is a mixture of drugs which keeps you unconscious and pain-free during the operation.

Drugs are injected into the blood-stream through a vein and/or breathed in as gases or vapours into your lungs. A breathing tube or mask is then placed into your throat to help you breathe while under the anaesthetic. The tube is removed before you fully wake up

Following a General Anaesthetic

Initially, after a general anaesthetic some people become agitated and confused in thinking and behaviour, whereas others become quiet and withdrawn. Some patients wake up not knowing what has happened to them and why they are in hospital.

Some patients are incoherent, shouting and swearing. Some people are emotional, tearful anxious, displaying anger or aggression.

Doctors and nurses are very familiar with this kind of confusion following a general anaesthetic. Most patients recover completely once fully awake.

A general anaesthetic may affect your judgement for about 24 hours.

During this time you must not:

  • drive any type of vehicle.
  • operate machinery including cooking implements.
  • make important decisions or sign a legal document.
  • drink alcohol, take other mind altering substances (only if authorized by your anesthesist).

You shouldn’t smoke after general anesthesia.

Important things to do after general anesthesia:

Breathing Exercises

After an anaesthetic breathing exercises help to move phlegm.

How to do breathing exercises

Sit comfortably supported with pillows and with your knees bent. Take a low, slow breath in through your nose and hold for a count of two. Sigh the air right out slowly. Repeat 3 times.

These exercises should be repeated every hour until you are walking well and have no phlegm.

Moving in Bed

It is good for your circulation to move in bed - it helps to prevent pressure and moves any trapped wind.

With your legs straight, briskly circle or bend and stretch your feet up and down from the ankles for 30 seconds.

Repeat this exercise every hour until you are up and about fully mobile.


In summary while there are some risks associated with anaesthesia and Surgeons, anaesthetists and nurses work as a team to minimise the chance of any unexpected harmful events. However, it is very important that you alert the anaesthetist if you have had any difficulties during a previous general anaesthetic procedure.

Further information regarding Anaesthesia is available from the Royal College of Anaesthetists.


Side effects & risks

Anaesthetic risks are thought of in terms of side effects and complications. Side effects are the secondary effects of the drug or treatment. They can often be anticipated but are sometimes unavoidable. Almost all treatments - including drugs - have side effects.

Unpleasant side-effects of a general anaesthetic, such as a sore throat or sickness, do not usually last long. Some are left to wear off, others can be treated.

Complications are unexpected and unwanted events that occur during treatment. The patient may have an unexpected allergy to a drug or damage to their teeth caused by a difficulty in placing a breathing tube.

Below is an index of some side-effects and risks associated with general anaesthesia:

Very common and common

Sickness or feeling sick - some operations and anaesthetic drugs are more likely to cause sickness than others. Often people who experience travel sickness or have suffered post operative sickness before are more likely to suffer nausea and sickness

Other reasons for nausea and vomiting are:

Being without food and drink for long periods? It’s only necessary to starve yourself of solids for six hours and water for three hours prior to surgery.

Being anxious about surgery can cause nausea and vomiting.

Things to reduce nausea include:

Avoid sitting up or getting out of bed too quickly.

Avoid drinking and eating immediately after your operation - start with small sips of water and slowly build up to larger drinks and light meals.

Good pain relief is important.

Take slow deep breaths - this can help to reduce any feelings of sickness.

Sore throat

During any general anaesthetic your anaesthetist must make sure that you can breath freely and will choose one of two methods to achieve this - either by placing a tube or special mask airway into your throat. During insertion (while you are asleep) the tube or mask can cause irritation or damage to your throat. Some anaesthetic gases and drugs can dry your throat and contribute to a sore throat. In some cases symptoms disappear without specific treatment, gargling can help, simple throat lozenges and drinking plenty of clear fluids once able, also help to alleviate a sore throat.

Dizziness, blurred vision

Anaesthetic or loss of fluids may lower your blood pressure and make you feel faint. Fluids and / or drugs can be given to relieve this.


Some people shiver during the recovery period. Shivering is an involuntary process, which may affect various parts of your body. In general shivering after an operation is due to a fall in your core-central-body temperature, most drugs used in anaesthetic contribute to this fall by reducing your natural ability to regulate your own temperature.

Parts of your body are exposed to a cool environment during the operation, this further contributes to heat loss. Steps are taken to keep you as warm as possible, these include heated blankets, warming any intravenous fluids given to you in theatre. Shivering will stop on its own and although distressing it is generally not dangerous, however it does increase the body's need for oxygen, so you may be given additional oxygen via a mask.


This may be due to the effects of the anaesthetic, to surgery, lack of fluid or anxiety. It will usually subside and can be treated with pain killers if necessary.


This is a side effect of opiates and some other pain killing drugs, it does not last long.

Aches, pains and backache

Some people feel aches and pains in other areas and this may be a pre-existing pain or just from lying on the operating table.

Pain during injection of drugs

Patients may experience an odd feeling or a mild burning sensation.

Bruising and soreness

This can happen around the injection or drip site. It may be caused by a thin vein bursting, movement by a nearby joint or infection, it normally settles without treatment but if it becomes uncomfortable the position of the drip can be changed.

Confusion or memory loss

This is common among older people and is usually temporary.

Uncommon side effects and risks


Depression is a common condition nowadays. Cosmetic surgery is not the treatment for it and therefore a depressed patient who is unhappy with their appearance will remain depressed. Surgery may induce a mild depression some time after the operation. Patients with chronic depression may not be considered suitable candidates for cosmetic surgery. A letter from G.P or psychiatrist outlining a medical summary together with current medication may be required. We would also ask for their opinion as to your suitability for surgery.

Many patients develop a depression after surgery and general anesthetic. This is very important and should be referred to your GP immediately for treatment.

Bladder problems

Some people can have problems passing urine and in some cases a tube may be inserted to allow the urine to pass.

Slow breathing / depressed respiration

Some drugs may cause slow breathing or drowsiness, these symptoms can be treated.

Chest infection

After an anaesthetic there is a risk that you may develop a chest infection. Anaesthesia and surgery interfere with the normal ways in which the lungs keep themselves clear of secretions and infection. Chest infections are more likely if you have had abdominal surgery, certain patients are at a higher risk of developing a post operative chest infection.

Damage to teeth, lips and tongue

During general anaesthetic it is possible for your teeth to be damaged. This happens to 1 in 4,500 general anaesthetic procedures. Serious damage to the tongue is rare, minor cuts or bruising to the lips and tongue are common. These injuries heal very quickly and can be treated with simple ointments such as vaseline.

Teeth or dental work such as crowns, bridges or veneers may get broken, chipped, loosened or completely removed by accident. The upper front teeth are the most frequently damaged, this is caused by the use of artificial airway device which keeps you breathing safely during your operation. Occasionally the air-way may be difficult to insert and more force than is normal is used, this can sometimes result in damage to the teeth, lips or tongue Even the most skilled anaesthetist can encounter these difficulties.

Some patients with listed complications can be more prone to the risk of damage to their teeth.

Reduced mouth opening

People who are overweight

Reduced neck movements / Teeth in poor condition

Prominent upper teeth or small lower jaw

An existing condition getting worse

Existing or past illnesses may affect your recovery so it is very important that your anaesthetist is aware of any past medical condition.


During the operation you are closely monitored and the anaesthetist can prevent your anaesthetic becoming too light. If you think you may have become conscious during your operation you must inform the anaesthetist. In most cases when people think they have become conscious its usually memories of the beginning and end of their procedure when they are semi-conscious - this is normal.

Rare or very rare risks

Damage to the eyes

The anaesthetist takes great care to protect your eyes during surgery, you may have your eyes taped closed or have eye ointment applied.

Corneal abrasions can happen to anyone having a general anaesthetic. It is more likely to happen if you need to be turned face downwards for your operation and is caused by rubbing on the bed linen or surgical drapes. Other damage can happen because the eye does not close fully during the anaesthetic. The cornea dries out and sticks to the inside of the eye ball and the abrasion occurs when the eye opens again.

Even with eye protection, some patients react to the ointment or the tape when it is removed, which can leave a bruise if the skin is thin or delicate.

A corneal abrasion can be very painful, healing can take several days. Every precaution is taken to protect your eyes during a general anaesthetic.

Serious allergy to drugs

Allergic reactions will be treated quickly by your anaesthetist.

Extremely rarely this can result in death, therefore you must inform your anaesthetist of any allergies or occurrences that may affect your recovery.


Deaths are very rare and are usually caused by several factors arising together.

Preparing for your operation

4 weeks before your operation

Stop smoking.

If you have recently been prescribed antibiotics for chest or throat infections you will need to have finished the course at least 4 weeks before surgery.

2 weeks before your operation

For your own safety, you must not take any of the following at ANY TIME, two weeks prior to surgery: Aspirin, Alcohol and Vitamin Tablets

These products dilate the blood vessels and could increase the risk of bleeding after surgery.

1 day before your operation

Should you develop a cough, cold or flu symptoms prior to surgery contact me.

If you are currently taking medication of any kind, you will need to bring it with you.

Pre-operative preparation

In order to prepare you for theatre, we will ask you to take a shower before putting on a gown.

You will be able to use your own soap or shower gel; however you should not use any perfume, Talcum powder or body lotion after you have washed as these products interact with the antiseptic used in theatre.

Nail varnish and make up must also be removed to comply with our infection control regime.

To ensure your safety during your procedure false nails and jewellery must be removed, including all piercings.


Before you arrange your operation you will need to take these considerations into account:

After surgery you will probably need to convalesce for at least 7 to 14 days.

Therefore, if you work you will need two weeks leave. If your job is quite strenuous, involving lifting I may advise you to take a longer period to recover.

Your procedure requires a general anaesthetic, therefore you will have to stay overnight at the hospital. If you have children you will need to make suitable arrangements for them to be looked after by your partner or a responsible adult.

If you smoke it is very important that you stop prior to surgery and post-operatively to improve the healing of resultant scars.

Immediately after surgery you must not lift heavy objects. Women with small children will need to ensure they have the help and support of their friends and family while they convalesce.

Please inform if you have any cold or flu symptoms prior to surgery. If you are ill I may need to postpone your procedure.

You should not eat or drink after midnight the night before if your operation is booked for early in the morning. Late admissions will be advised regarding this matter.

Please take note

All surgery carries an element of risk. Cosmetic Surgery procedures may be voluntarily undertaken, however, that does not mean that complications will not happen.

We have listed the risks associated with your procedure and during your consultation your I will discuss them in greater detail.

Below are three key points that we need you to understand:

  1. The importance of your medical history
    During your pre-consultation I will help you to complete a medical history questionnaire. You must provide me with every aspect of your medical history, including illness, operations, drugs, allergies, sickle cell and any family history of disease. If you withhold any relevant information then you are potentially placing your own well being at risk.
  2. Pre-operative screening
    After I have finished your consultation and reviewed your medical history it may be appropriate for pre-operative tests. Some of these are routine and will be covered in the fixed price package, however, additional costs may be necessary if the I requires further tests. These tests and information will help reduce the post-operative risks and promote a good recovery.
  3. The role of your GP
    In some cases, prior to surgery, it may be essential me to contact your own doctor or any other relevant specialist that you have previously seen. I reserve the right to contact your G.P at any time, should I feel that this is necessary. I would only establish this contact with your full consent, should you withhold this consent I may feel unable to continue with your procedure.
    In the case of an emergency I would contact your GP.

Post Operative care and conduct

Please read the following carefully. It is important information and may prevent unnecessary concern or problems at a later stage. Together with your pre-operative counselling information most of the questions you are likely to have following your discharge are dealt with in this page. The first point to deal with is the arrangement of your first post-operative appointment, this is an important appointment. I will instructed that your sutures / stitches are removed on this date and you will be aware from your initial counselling information that if it is missed the hospital will not be able to guarantee the outcome of any surgery. If you do need to re-schedule this date it may have an affect on the healing process, you should make every effort to attend. If you are unable to attend any appointment please contact me asap.

After you are discharged from the hospital you must NOT do the following for 48 hours

  • Drink alcohol
  • Take aspirin or any product containing aspirin
  • Exert yourself at all
  • Eat Garlic
  • Take vitamin E supplements

Taking these measures will assist in your recovery

  • Smoke nothing - or very little for the first 2 weeks
  • Follow the discharge instructions
  • Avoid sporting exercise, including swimming for 6 weeks
  • Gentle exercise such as walking is beneficial

Please do not request me variation of the above do's and don'ts. No reason exists for me to take risks on your behalf for which we would be responsible.

Simple Painkillers

You will be prescribed analgesia to take home following your surgery, some patients may prefer to take the pain killers which they usually take - do not take both. Always read the instructions on dosage over 24 hours.

After your operation you should use simple, regular pain killers such as paracetamol.

Although these drugs may not completely treat your pain, if you take them regularly they reduce the amount of other painkillers you might need.