A woman in her early 30’s who is bothered by a complete split of her left ear lobe. After discussion this is most likely from sleeping with her earrings in, as she does not have this problem on her opposite ear. She is shown before and again, 3 months after repair of her cleft earlobe in the office under local anesthesia. I typically wait 3 months to re-pierce the ears and she is shown just after piercing as well. Scars will typically get thicker for 6 weeks and then soften and fade over the next 2 years. By 3 months her scar has started to settle.
A 13 1/2 year follow-up on a woman who was bothered by the appearance of her nose. This was before computer simulation and I have sketched out the changes that we wanted to make in a side view. She had deviation of the septum a marked collapse of the internal nasal valve ( a Breath rite strip is used to temporarily improve this sometimes). She is shown before and again, 13 1/2 years after an open rhinoplasty with bilateral spreader graft placement as well as placement of a columnellar support strut from the septum to stabilize her nasal tip. Her nose is no longer blocked and she loves the natural appearance of her nose after surgery. The dorsum is straight and the tip is refined in appearance.
A woman in her later 50’s with a partial cleft of her earlobe and a drooping appearance of her earlobe. She is shown before and again, 3 months after a earlobe lift/repair. In an ear lobe lift, the earlobe is swung back and forth past an imaginary central point to mark a precise wedge. This is excised along with the earlobe cleft and by removing the excess earlobe from atrophy and aging gives a more youthful and “lifted” appearance to the lobe.
A man in his later 20’s who has gages of his ears. He has especially overstretched his right ear and has some excess skin behind the earlobe as well. He has been hired for a new job but his employer will not let him work until the gauges are corrected.
He is shown before and again, 3 months after bilateral gauges repair under local anesthesia in the office. Scars typically become thicker and redder for 6 weeks and then fade over the next 2 years. At 3 months he already has an excellent appearance and can expect the redness of the scars to continue to fade with time. He does not plan to have his ears re-pierced.
A man in his late 20’s who is bothered by prominence of his lips He is shown before and again, 10 months after a “bikini lip reduction” of the upper and lower lips. His after photo has a different perspective and angle as it was kindly provided by the patient who has since moved across the country.
A woman in her 30’s who had gauged her ears up to the size of a dime and was bothered by their appearance. Her medical history is complicated by Factor V Leiden and also by being on Plaquenil for an inflammatory arthritis/Lupus condition. She is shown before and again, 3 months after gauges repair/earlobe lift. The redundant tissue was marked by swinging the earlobe back and forth past an imaginary point and marking the wedge of skin, which enclosed the prior gauge. Multiple layers of absorbable sutures were used to maintain the proper strength of the repair while healing, and she was instructed to protect her ears with bandaids while sleeping.
She is shown again 3 months after surgery and is thrilled with the new correction of her gauges and the beautiful and youthful contour of her earlobes.
A woman in her mid 50’s who has had a double cleft/ double tear of her left earlobe for 30 years. She thought this may be from wearing heavy earrings but has no tears on her right side which has been pierced in 3 places. The clefts were too close together to be repaired separately with individual incisions and maintain the blood supply to the central piece. But she has enough extra earlobe that a wedge was marked in a similar fashion to an ear lobe lift and was excised in the office under local and repaired in layers. She is seen again 3 months after repair and just after re-piercing the earlobe for her in the office.
A man in his late 60’s with a lentigo maligna melanoma of his right lower eyelid and a recurrent squamous cell carcinoma of his left cheek. He was pretreated with Aldara, an immune sensitizer to decrease the size of his lentigo maligna melanoma. He is shown 14 months after Full thickness skin graft to his right lower eyelid after modified Mohs excision, using his upper eyelid skin as a donor site. Enough skin could be harvested from his upper eyelids, improving their appearance and giving the perfect thickness and color of skin to match his lower eyelid. Two months later he had his recurrent SCCA excised with Mohs surgery.
He is also shown 1 year after Mohs excision of his left temple SCCA, with the defect being repaired with an extended Mustarde’ Cervical- facial flap. A large flap is developed from the left cheek, like a facelift flap, and the incision is continued in front of and then below the left ear, advancing the neck and cheek skin into the defect. The skin matches in color and texture, and continues to grow his normal beard.
A woman in her early 30’s with a partial split of her right earlobe over the last 3-4 years which keeps her from wearing earrings. She does not have enough laxity to warrant an earlobe lift. She is shown before and again, 3 months after a repair of the earlobe in the office. After placing a local anesthetic, the cleft portion of the earlobe is excised through the end of the earlobe and then repaired in layers. The scars typically get redder and thicker for 6 weeks and then begin to soften and fade over the next 12-24 months. By 3 months most patient’s earlobes are ready to be re-pierced.
An RN in her later 20’s with a history of gauges. She no longer liked the look anymore and also did not like the drooping earlobes. She is shown before and again, 3 months after repair in the office. A wedge was marked on each ear by swinging the earlobe back and forth past an imaginary point. This wedge included the enlarged hole from the gauge stretching. This technique corrected the drooping of the earlobe as well as the gauge, restoring her earlobe to a youthful contour. Her ears were re-pierced for her in the office at the 3 month visit.