An interesting case of a man in his early 80s with a squamous cell carcinoma of his chest. I sent him to our local Moh’s surgeon for excision and then planned his repair. The key was to design the rhomboid flap so that it would not distort the location of his nipple and leave him with significant asymmetry. He is shown after Mohs and again, 2 1/2 months after flap repair under local with IV sedation at the hospital. The scar will typically now fade over the next 2 years. He can take his shirt off at the pool without feeling deformed.
A woman in her mid 70’s with squamous cell carcinoma of her lower lip. She had a large defect after Mohs excision which I was able to repair with an advancement of the non-sun exposed mucosa from inside the lip. She is shown before and again, 9 months after surgery. Her lip motion is normal after surgery.
A woman in her mid 70’s who is bothered by a left cleft ear. She has had this repaired elsewhere in the past but it has recurred. Her case is complicated by needing to take Coumadin (Warfarin) to prevent blood clots. She has a double piercing in both ears but plans to only use one piercing down the road. She is shown before and again, 3 months after repair under local anesthesia in the office. Because she is not going to use the second hole on each earlobe, the left ear was re-pierced at her request to best match the hole on her right ear. It is the best centered position on the repaired earlobe to match the hole on her opposite ear but would be too close to the old hole if she wanted to still wear two earrings.
A woman in her early 60’s who is bothered by a low piercing on her ear as well as drooping of the earlobes with her earrings in place. He originally had her ears pierced by a friend with a potato, an ice cube and a needle!
She is shown before and again, 15 months after an earlobe lift. We will normally see patients back at the 3 month mark to re-pierce the ears but she was not able to come in sooner. Scars continue to fade however, and at the 15 month mark have faded quite nicely. The earlobe is no longer droopy giving it a more youthful appearance. In an earlobe lift, the earlobe is swung back and forth past an imaginary center point to mark a wedge of excess earlobe that is removed during the repair.
A woman in her early 30’s with a partial cleft of her left year since having it pierced at a very young age. Because of the size of the cleft she has not been able to wear earrings for years. She is shown before and again, 4 months after repair and just after repiercing in the office.
A student in her early 20’s with a partial cleft of her right ear which has been present for several years and allows her earrings to fall out. She is shown 3 months after repair under local anesthesia in the office. Scars will typically increase in redness and firmness for 6 weeks as the earlobe heals and then begin to fade and improve over the next 2 years. This is a typical appearance for the 3 month timeframe and a typically a good time to return to have the ear repierced.
A 14 year old young woman with a partial cleft of her right ear which she attributes to wearing heavy earrings. She is shown before and again, 3 months after repair in the office under local anesthesia. Scars typically get thicker and redder for 6 weeks and then begin to fade over the next year or longer.
After re-piercing her ear in the office, I have recommended that once the new piercing heals after 3-4 weeks that she gets in the habit of removing her earrings while sleeping to prevent recurrence. Her left ear is normal so the weight of the earrings is less likely of a factor then having the earrings in while sleeping. When the ear moves against the pillow, the earring post can slowly cut through the earlobe like a wire cutting through a cheese and is the more likely cause.
A man in his later 20’s with gauges of his ears who no longer likes the look. He is shown before and again, 4 months after reconstruction of the earlobes in the office under local anesthesia. Scars are typically at their reddest and thickest at 6 weeks and then begin to soften and fade over the next 18 -24 months. He is thrilled to have a normal earlobe contour again.