I started using this procedure for hematomas. It is much less painful and does not involve as much aftercare. In the past I've used the surgical method. The cause of ear hematomas can be from chronic ear infections, reactions to food or other things,, bites , and just shaking the head alot. I've noticed lots of dogs with chronic ear infections respond to less allergens(wheat and other grains and beef). I wrote Dog Dish Diet and Feed Your Pet to Avoid the Vet to help pet owners feed their pets better quality ingredients. http://dogdishdiet.com/ordernow