A woman of color in her early 20’s who had had a complete tear of her right earlobe for a few years. She is not sure how this happened originally but does sleep on this side and did sleep with her earrings in. She is shown before and again, 3 months after repair in the office.
A woman in her early 60’s with a complete cleft of her right ear and a partial cleft of her left ear. She does sleep with her earrings in and notice that this gradually became longer until it tore through completely. She initially had her ears pierced at the age of 8. She also has a droopy appearance of the earlobes. She is shown just before and again, 3 months after bilateral earlobe lift when she returned to have her ears re-pierced. With an earlobe lift, a wedge is marked by swinging the earlobe back and forth across an imaginary central point. As this wedge of excess tissue is removed it “lifts” the earlobe and gives is a more youthful appearance. Scars typically become thicker and redder for 6 weeks and then fade and improve over the next 1 1/2- 2 years.
A health care professional in her early 60’s with a large basal cell carcinoma of her right upper lip. She is shown just after Moh’s excision and then again, 5 months after a paranasal advancement flap. Scars will typically continue to fade and improve over the first two years.
A woman in her mid 50’s with a partial tear of her right earlobe for many years that makes it difficult to wear earrings. She did not remove her earrings for sleeping and this is the side that she sleeps on.
She is shown before and again, 3 months after repair in the office under local when she returned for re-piercing in the office. I recommend that she clean the new piercing with hydrogen peroxide a few times a day and wear a Bandaid at night while sleeping for the first 3-4 weeks. At that point the piercing hole should be healed enough to change earrings and she should remove them while sleeping. My theory is that the earring post levers back and forth against the earlobe as it rubs against the pillow, slowing cutting through the earlobe like a wire cutting through a cheese.
A retired nurse in her late 70’s with a spindle cell pleomorphic cancer of her right forehead. She is shown just after modified Mohs excision by the Mohs surgeon and again, 7 ½ months after an inverted T-plasty repair of the forehead followed by postoperative radiation. With an inverted T pasty, the defect is converted to an upside down “V” and the sides are advanced and repaired to give the appearance of an upside down “T”.
A woman of color with a partially torn right earlobe. This makes her earrings hang at a funny angle. She has torn this before and had it repaired before. She does sleep with her earrings in place. She is shown before and again, 3 ½ months after repair in the office. It is great to fix things but it is better to prevent things. So I have recommended that she get in the habit of removing her earrings while sleeping to prevent this from tearing again. My theory is that the earring pulls back and forth across the pillow while sleeping and slowly cuts through the earlobe like a wire cutting through a cheese.
A man in his early 40’s who is bothered by prominent ears. He reports being teased when he was younger and being called “Elephant” and other names. He is finally at a point where he can take care of his ears. He is shown before and again, just 6 weeks after bilateral otoplasty. The cartilage was reshaped by a combination of rasping with a Dingman otoabrader ( designed by one of my professors at the University of Michigan, Dr. Reed DIngman) along with excision of excess conchal cartilage and sutures to reshape the ear. He is thrilled to have a normal appearance to his ears. There is still some mild redness from the healing process which should continue to fade with time.
A woman in her early 80’s with a basal cell carcinoma of her left ala. The ala can be a challenging area to reconstruct and typically requires several stages. She had a first stage with a nasolabial pedicle flap and ear cartilage graft. She returned to have this divided 4 weeks later. A second stage to better refine the flap contour was performed 9 months later. She is shown before, just after Moh’s excision and again, 5 months after her final procedure.
A woman in her mid 70’s s/p moh’s excision of a squamous cell carcinoma (SCCA) of the lower lip. The lower lip is prone to more sun exposure and when a patient develops a scca in this area they typically have “actinic cheilitis” which is sun damage of the rest of the pink portion (vermillion) of the lower lip that is prone to develop more skin cancers. It is usually a good idea to remove the entire remaining sun damaged vermillion and advance the lip forward- called a “lip shave” or “vermillionectomy”. That was done here and her lip is shown 11 months after surgery-the scar Is nearly imperceptible even with a close up view and the lip has normal function and motion, but the vermillion that has been brought forward from inside the lip has not had chronic sun exposure and is not therefore prone to develop another scca.
A woman in her early 70’s with a cleft of her right ear where her earrings tore through and age related drooping of both ears. She is shown before and again, 3 months after a bilateral earlobe lift incorporating a repair of her cleft. With a lift, the earlobe is swung back and forth across an imaginary midpoint to precisely mark a wedge of excess earlobe to be excised, “lifting” the earlobe. She is thrilled with the more useful. Her earlobe tear was most likely from sleeping with her earrings in. After re-piercing she will wear a Bandaid at night for the first 3-4 weeks and then get in the habit of removing the earrings when sleeping. Most patients tend to sleep more on one side than the other, and the earring post gets pushed back and forth catching on the pillow an can slowly cut through the earlobe like a wire cutting through cheese.