After Your Operation
You will have dressings around your ears and head. You will be placed in bed in a head up position with pillows behind your head.
You can expect to have some discomfort when you wake up after otoplasty. You will be placed in a position where your head is elevated. This position will help to minimise pain and discomfort. You will need to remember to move your legs to keep the circulation flowing and to take deep breaths to expand the lungs.
Care should be taken when moving around in bed. Pain that develops and becomes worse on one side should be brought to the attention of your surgeon.
You will need to take painkillers as provided. It is recommended that you avoid aspirin or aspirin based products for pain relief, as they will promote bruising and bleeding. The usual medications given in the postoperative period consist of panadol, panadeine, panadeine forte, panamax, digesic, and endone. These medications may be combined with anti-inflammatory medications such as vioxx, celebrex, or brufen. Make sure that you have a postoperative pain regime at the time of discharge and that you understand the medications that you are taking and what they are designed to do for you.
One or two sleeping tablets (normison, temazepam, ativan) may be taken at night, if necessary, to help with sleeping in the first few days after surgery.
Your surgeon may prescribe a course of prophylactic (preventative) antibiotics.
Nausea and vomiting
Nausea and vomiting may be due to the anaesthetic or post-operative medication (like pain killers or antibiotics). Apart from being unpleasant, vomiting will cause an increase in swelling. Medication to prevent nausea and vomiting may be required.
If prolonged, nausea and vomiting may be related to a complication like infection and may cause dehydration. You need to inform your surgeon of prolonged nausea and vomiting.
Bruising of the ears after otoplasty will still be evident when bandages are removed post operatively. Most bruises will resolve by 2 weeks. Gentle massage with a moisturising lotion (Sorbolene), twice daily may help to dissipate bruising.
Bleeding or ooze
There may be ooze of blood from any of the suture lines and this may appear from under the bandages. Any ooze coming from beneath the bandages should be reported to your surgeon.
Swelling can occur for 4 to 6 weeks after otoplasty and sometimes, intermittent swelling may take up to 6 months to settle. Please ask your surgeon how long swelling should take to resolve. Swelling lasting longer than this time may be due to a complication, and should be reported to your surgeon.
Dressings following otoplasty are usually removed 6 to 7 days after your surgery. The surgical bandages should not be disturbed prior to removal by your surgeon. You may need to take time away from the public eye for the duration of your bandages. Please ask your surgeon how long the dressings need to stay on.
After removal of your bandages you may need to bandage the ears at night for 2 weeks to prevent sleeping on bent up ears. Check with your surgeon if you are able to shower.
Sutures may be beneath the skin and will absorb with time. The aim of absorbable sutures beneath the skin is to provide wound support for a longer time than external skin sutures, so that scar strecth is minimised.
Occasionally the body will want to extrude these sutures. A sore or a pimple on the suture line may indicate an underlying suture trying to break through the skin. This suture can easily be removed. Antibiotic ointment or betadeine may be required until the area heals.
Sutures may be present in the skin. These sutures will require removal at some stage after the bandages are removed. The normal time frame is 6 to 10 days depending on the surgery and the location on the ear. Suture removal is usually arranged with the surgeon. You will be able to shower and wash your hair after suture removal.
Having a shower and getting your sutures wet may be permitted by your surgeon after the dressings have been removed. An antibacterial soap (Sapoderm, Gamophen) may be recommended.
You will need to pay attention to washing and carefully drying the suture line with a clean cotton bud. Antibiotic ointment (chloromycetin ointment) or soft white paraffin (vaseline) may be applied along the suture lines to moisten any crusts and to allow removal of the crusts.
Please check with your surgeon and ensure that you follow your surgeon’s instructions about wound care.
Otoplasty is commonly performed under general anaesthesia and as day surgery.
If you are going home after day surgery a family member or friend must drive you because you have had an anaesthetic and someone should stay overnight with you for the same reason. You may need help from a relative or friend at home during the first few days after your otoplasty.
If you have any questions about these matters, please speak to your surgeon.
The effects of an anaesthetic may still be present 24 hours after your procedure, even if you do not feel them. Your reflexes will be slower and you are at risk of injury. It is illegal to drive while under the influence of a drug (even a prescribed one) and you could be charged.
Do not make important decisions or sign legal documents for 24 hours after an anaesthetic. Take care with alcohol intake after surgery because medications and alcohol may interact with the residual anaesthetic. Discuss your normal medications with the anaesthetist.
Readmission to hospital
Rarely you may need to be re-admitted unexpectedly to hospital. The most common cause is persistent nausea and vomiting, anxiety, the need for unexpected additional pain relief or for treatment of unexpected complications of surgery such as bleeding, wound problems or infection.
Too much activity too soon will risk delays in healing or increase the risk of complications. Try to walk upright and avoid bending. Sleeping head up and with 2 or 3 pillows behind your head will help to reduce pain, swelling and bruising. Try to avoid any straining or rushing around.
You may go to the bathroom, walk around the house sit and watch TV, etc., but no matter how good you feel do not clean the house, engage in heavy manual work, go to the gym etc. for 4 weeks following your surgery. For adults, this also applies to sexual activity.
Slow walking on the flat for exercise is often therapeutic in the early post-operative period. More strenuous exercise like fast walking, running, swimming or tennis may commence after 2 weeks.
Please ask your surgeon when you can start exercising.
Your post-operative diet should consist of fluids initially then soft food that is easy to prepare. If you have any postoperative nausea, carbonated sodas and dry crackers may settle the stomach.
Although not proven, there is some suggestion that multivitamins prior to and after surgery may aid in wound healing. Avoid mega dosing on vitamins prior to surgery.
Smoking reduces capillary blood flow to the skin and may result in delays to wound healing or complications of your blepharoplasty. Smoking not only affects wound healing; it also increases the risk of bleeding, wound infections, post-operative chest infections. Any coughing may cause bleeding. Smoking also increases the risk of developing a blood clot in the legs that can travel to the lungs. It is recommended that you cease smoking at least 4 weeks prior to your surgery and for 4 weeks after.
Medications and alcohol may interact with the residual anaesthetic and prescription pain medicine.
Alcohol also dilates blood vessels and may increase the risk of postoperative bleeding.
It is recommended that you avoid alcohol for the first three days after surgery and restrict your alcohol intake for the first month.
It is recommended that you do not drive until you are happy that your vision is normal and no longer blurry. To be able to drive safely you must have full use of your reflexes to drive, and any post-operative discomfort will inhibit your reflexes. If you have any doubt, don’t drive.
You may resume driving when you feel you are able, but it is advisable to discuss this with your surgeon or check with the road traffic authority first.
You must allow yourself adequate recovery time. You will have a bandage around your ears for one week after your otoplasty. Too much activity too soon will increase the risk of complications such as bleeding and delayed healing.
It would be wise to ensure you have adequate time off work (and schoolfor children) to allow sufficient time for your body to recover from the effects of surgery.
Discuss the expected time for recovery with your surgeon prior to your surgery and allow plenty of time for adequate recovery.
Everyone heals at a different rate. The ability to heal is variable and depends upon a number of factors such as your genetic background, your weight, your overall state of health and lifestyle (exercise, diet, smoking, drinking, etc.). Your attention to preparing yourself for surgery will be manifest in your post-operative recovery. Many people believe the surgeon “heals” the patient. Not one person can make another heal. Your cooperation and close attention to pre and post-operative instructions is extremely important and is in your best interest.
A major factor in the course of healing is whether you follow the instructions given by your surgeon and the nurses in the surgery. Such guidelines are designed to promote the healing process and to prevent the occurrence of anything that may interfere with your recovery.
It is imperative that you recognise that you are a partner in this process and have a responsibility to follow instructions carefully. The instructions, based on broad experience, are designed to give you the best opportunity for healing without delay or surprise.
Depression is a normal reaction to surgery. The third day following your surgery may be the worst. You may be teary. It is not uncommon to experience a brief period of “let-down” or depression after any surgery.
You may subconsciously have expected to look and feel better “instantly,” even though you rationally understood that this would not be the case.
Day 3 post surgery may be the worst. As healing occurs, these thoughts usually disappear quickly.
If you feel depressed, understanding that this is a “natural” phase of the healing process may help you to cope with this emotional state.
Support from family and friends
Support from family and friends can be very helpful, but because they may not understand what constitutes a normal postoperative course, their comments may unintentionally create emotional turmoil for you.
The staff at the surgery and your surgeon will tell you honestly how you are doing and what to expect.
Please trust in your surgeon’s knowledge and experience when your progress is discussed with you.
Complications are infrequent. When complications occur, it is seldom a consequence of poor surgery or poor postoperative care. Complications are more likely to be a result of the variable healing capacity or a failure to follow post-operative instructions. You will be assisted in every way possible if a complication occurs.
Should the unexpected occur, please understand that it is important to follow the advice of your surgeon and nursing staff in order to treat it as effectively as possible. Your surgeon and the nursing staff will ensure that you have support and assistance during this difficult time.
It is very important that you follow the schedule of appointments established for you ( or your child) after surgery. Appointments to see the nurse or the surgeon should be made before or immediately after discharge from hospital. The review appointment may be the next day or up to one week following surgery.
If no appointment has been made, you must ensure that you contact your surgeon and make a follow up appointment. If you have any concerns don’t feel that you are bothering the surgeon or the staff.
If need be, you (or your child) can be seen prior to any arranged review appointment to sort out any concerns.
Occasionally the result of your surgery may not be totally perfect. If you feel that you can focus on the overall degree of improvement instead of any small lack of perfection, then you will reap the benefits of the results of your operation. If small imperfections will prevent you focusing on the degree of improvement after your surgery you probably should not have had an operation.
Your surgeon will use their expertise and experience in their surgical techniques to achieve the best results and ensure their patients receive the most advanced surgical techniques available. They keep updated by attending, national and international aesthetic conferences and seminars regularly.
The surgery performed may not necessarily relate to the methods that are sometimes promoted, or advertised in popular magazines, newspaper articles or on television.
The rate of revisional surgery, even in the most skilled surgical hands, can never be zero because patient and surgeon can control only some aspects of the outcome.
Minor adjustments or additional revisions following cosmetic surgery may be necessary in up to 5% of patients. Revisional surgery is performed after the first postoperative year (12 months after surgery) because resolution of swelling and stabilization of the final appearance takes at least that long.
During the first year after surgery irregularities, asymmetries or poor contours may sufficiently improve without surgery, so very small imperfections following surgery should not be revised.
Revisional procedures are less predictable and involve more risks. You must consider any revisional surgery carefully after discussion with your surgeon.
If revisional surgery is required you may incur further surgical, anaesthetic, pathology and hospital fees. These fees may be covered if you have private health insurance, depending on your level of cover. These fees will be your responsibility and you will need careful financial planning you before you embark on any form of cosmetic surgery. Private Health Insurance is strongly advised for any cosmetic surgery.