To attach the ear, three plastic surgeons performed two surgeries on his arm in Los Angeles.
His arm was chosen because his preferred option, his head, was not deemed safe. In the first surgery, taking three hours, surgeons inserted a kidney-shaped silicon pouch scaffold under the skin in his arm and suctioned the skin over the scaffold.
Afterwards he injected sterile saline solution into the pouch. As saline filled the pouch it enabled his skin to stretch over the pouch scaffold. "I didn't particularly like sticking needles into my arm."
His arm was swollen to the size of a tennis ball, he said.
The surgery was not without complications, he said. After his second surgery later in 2006, his arm became badly infected.
During the six months after the surgeries, the ear had tissue in-growth - when cells were encouraged to grow into the construction. The ear grew its own blood capillaries or "vascularisation".
The idea was a logical step after Stelarc's other works such as an attached mechanical hand and 3D printed arm with rubber muscles.
"I wanted to construct a soft prothesis. The extra ear is a permanent part of my body.
"Art is not necessarily rational."
His partner, also an artist, had spent several years dissecting human bodies and was quite okay with what he was doing and understood, he said.
Born Stelios Arcadiou, the artist changed his name legally in 1971 and along with his art is a distinguished research fellow at Curtin University in Perth.
Recently in Pittsburgh he talked to a plastic surgeon who is an expert in stem cells. "We discussed the future possibilities. I've already started the electronics for the ear." Otago Daily Times
