Plastic surgeon Tony Tonks performs the half-hour surgery under local anaesthetic at least once a month in Canberra.

"Perforated ears or cleft of the ear, depending on how they do it, the cost in my operating theatre here is $350 and there is a small Medicare rebate on that,'' Dr Tonks said

"The excess [skin] is excised and the bits that are left are reshaped to form an ear lobe.''

Dr Tonks said skin had an amazing capacity to snap back into shape and surgery was only necessary when the hole was larger than 10 millimetres.

"It's a bit like a piece of chewing gum. If you pull a piece of chewing gum a little, it will snap back but if you pull it too much, it loses its elasticity and won't. Skin is the same it can snap back successfully.''

Dr Tonks said Canberrans were conservative and his ear reconstruction clients wanted to look ''normal''.

His most frequent surgeries are for breast augmentation and reconstruction.

"Breast augmentation: I do two to three a week, so more than 100 pairs a year. Today, I've seen three new patients and four post ops.''

And Canberrans favour the natural look.

"Average implant is usually 300cc, that's about two cup sizes. So if you start with an A, it will give you a C minus. If you start with a B it will give you a D.''

He said that was a smaller implant than those used in other areas of Australia including the Gold Coast, where the average implant was 350cc.

"The patients I have who want larger implants are from Sydney and I have generally operated on them for other things in the past.''