A student in her early 20’s who had nasal obstruction before surgery which caused her to snore at night and wake up with a dry mouth in the morning. She is also bothered by a dorsal “hump” and a drooping appearance of the tip of her nose. She was diagnosed with vestibular stenosis or collapse of the internal nasal valve. This can be improved temporarily with Breath-Rite” strips but can be improved surgically with the placement of “spreader grafts”. This is a strip of cartilage in the shape of a match stick that is placed between the top of the septum and the upper lateral cartilages to prevent collapse when a patient inhales through the nose. She is shown before and again, 5 ½ weeks after an open rhinoplasty with placement of spreader grafts. Her breathing is normal now and she loves the early improvement in the shape of the nose. The nose will typically continue to develop more refinement over the next 3 years a s swelling slowly resolves.
A woman in her early 40’s with a partial cleft of her right ear as well as drooping of both earlobes. She is shown before and again, 3 months after bilateral earlobe lift/repair. With an earlobe lift, a wedge is marked by swinging the earlobe back and forth past an imaginary central point to precisely measure the amount of excess earlobe. Scars typically become thicker and redder for 6 weeks and then start to soften and fade over the next 2 years. At 3 months the earlobes are typically soft enough to be re-pierced in the office.
A woman in her early 50’s with a partial cleft and stretched out earlobes from sleeping with her earrings in. She wore tape for a few years on the back of her ear, but recently lost her diamond earrings on her right side and has not been able to wear earrings since. She is shown before and again, 3 months after correction of the cleft together with an earlobe lift. With an earlobe lift, the earlobe is swung back and forth across an imaginary central point to precisely mark a wedge of excess earlobe. This is removed with the repair, lifting the earlobe and restoring a more youthful appearance. She is shown before along with the markings, and again at 3 months, just after re-piercing in the office.
A 5 month follow up on a challenging case with a large defect of the nose after Mohs surgery for a Basal Cell Carcinoma that had been present for more than a year. He did not wish to have a 2 or 3 stage forehead flap and so we started with a large skin/fat composite graft from his cheek with the idea that if we did not like the result he could always return for the more complex procedure. He is shown just after Mohs surgery and again, 5 months after the skin/fat composite graft. The result is acceptable and should continue to fade a little with time.
A man in his mid 30’s who had gauges in college and the holes never shrunk enough after he removed them. He is changing careers and does not want the stigma of having had gauges. He is shown before and again, 3 months after bilateral repair in the office. Scars will typically continue to fade and improve for 1-2 years. He is already thrilled to have a normal appearance again.
An Rn in her early 50’s who has had one prior repair of her left earlobe 10 years ago by another plastic surgeon. She is bothered by drooping of both earlobes and a partial cleft or split of her left earlobe. She does sleep with her earrings in and this is probably the cause of her recurrent split. She is shown before and again, 3 months after a bilateral earlobe lift. With a lift, the earlobe is swung back and forth past an imaginary midline point to mark a precise wedge. When this is excised it removes the excess earlobe and “lifts” it. She feels that she “ has the earlobes of a 20 year old now”.
A woman in her early 50’s with a partial cleft of her left ear, which she has had for many years. This prevents her from wearing earrings because “they hang funny”. She does have a history of sleeping with her earrings in, which is the probable cause. She is shown before and again, 3 months after repair of her earlobe under local anesthesia in the office. Scars typically become redder and thicker for 6 weeks after surgery and then begin to soften and fade over the next 2 years. At 3 months, her earlobe is ready to be repierced in the office.