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Posts Tagged ‘earlobe repair’

Mini-Mommy Makeover Procedures

Sunday, May 19th, 2013

The concept of a Mommy Makeover plastic surgery procedure is about combining abdominal and breast reshaping in one operation. The breast and abdominal components are not new and include many well known procedures such as tummy tucks, breast implants, liposuction and breast lifts in whatever combination each individual women needs. While the effects of a Mommy Makeover can be dramatic, breast and abdominal procedures are major surgery with significant recovery as well.

But there are numerous other procedures of lesser magnitude that could also be lumped into the Mommy Makeover category and consist of a variety of ‘nips, tucks and sticks’ that create effects that mothers would also like. Here are some of the most noteworthy.

BOTOX  For reduction of those facial expression lines that come from the stress of balancing mother and wife roles, Botox injections are probably the most common injectable Mommy procedure.

Vi/PERFECT PEELS With only a few days of redness and flaking, these medium-depth facial peels are essentially painless to go through and provide a real boost to one’s complexion. A few of these a year will keep a mother’s skin radiant and glowing.

C-SECTION SCAR REVISION For those women that don’t need a tummy tuck and have a noticeable c-section scar with just a little pooch above it, widely cutting out the scar can produce a flatter upper pubic area. This scar revision can be combined with some lower abdominal liposuction for an additional and wider flattening effect.

UPPER LIP PLUMPING Some well placed Restylane or Juvederm injections into the upper lip has an instant youthful volumizing effect. This is particularly evident if the cupid’s bow and philtral columns are accentuated.

NIPPLE REDUCTION Breast feeding can elongate the nipple which can be a source of embarrassment and out of proportion to the size of the areola. Under local anesthesia, the nipple length can be reduced by half or more.

EARLOBE REPAIR Fixing stretched out ear ring holes or complete tears through the lobe can allow old or new ear rings to be comfortably worn again.

BELLY BUTTON REPAIR (Umbilicoplasty) Pregnancies can change an innie belly button to an outie due to a small hernia through the umbilical stalk attachment. Tucking the peritoneal fat back through the hole and reattaching the stalk of the belly button back down to the abdominal wall will recreate that an old inne look again.

EXILIS For those stubborn fat areas that just won’t go away despite some diet and exercise, this non-surgical fat treatment can easily fit into a busy mom’s schedule. It takes a series of treatments to see the effects but there is no downtime with 30 minute in-office treatment sessions.

These mini-Mommy Makeovers provide changes that do not require major surgery or recovery and can fit into anyone’s hectic schedule.

Dr. Barry Eppley

Indianapolis, Indiana

Postoperative Instructions for Earlobe Repair and Reconstruction

Sunday, March 17th, 2013

 

Repair of the earlobe is done for a range of conditions from a tear caused by an ear ring, stretching of the earlobe from gauging to traumatic injuries. The small size of the earlobe allows even complex repairs to be done under local anesthesia as an office procedure in most cases.

The after care instructions for earlobe repairs and reconstructions are as follows:

1. Earlobe repairs, whether a simple split repair or a more complete reconstruction, are associated with a minimal amount of pain in the first few days after surgery.  Usually narcotic pain medications are not needed and Tylenol or Ibuprofen are sufficient.

2.  There may be a small dressing (tape or bandaid) placed over the earlobes for the first 12 to 24 hours if the earlobe has significant reconstruction. Its purpose is to catch any oozing that may occur right after surgery. (usually there isn’t but as a precaution) It may be removed the next day. In smaller earlobe repairs there is no dressing used over the sutures.

3.  A light layer of antibiotic ointment needs to be applied to the sutures on the earlobes three times per day to keep them moisturized. This is done whether removeable or dissolveable sutures are used.

4. If permanent sutures are used, they will be removed by Dr. Eppley in 10 to 14 days after surgery.

5. You may shower, wash your face and shave (men) the next day. There is no harm is getting them wet with soap and water.

6. Do not pull on your earlobes or wear clip-on ear rings for up to one month after the procedure. Re-piercing your ears should wait at least 6 to 8 weeks after the earlobe repair.

7. You may wear eyeglasses or sunglasses after the procedure.

8. There are no activity restrictions after the surgery. You may exercise at any level at which you feel comfortable.

9.   You may drive right after the procedure. Since most earlobe repairs are performed under local anesthesia, many patients drive themselves to and from the facility.

10.  If any redness, tenderness, or drainage develops from the earlobe after the first week of surgery, call Dr. Eppley and have your pharmacy number ready.

Consent for Plastic Surgery: Earlobe Repair and Reconstruction

Saturday, March 16th, 2013

 

Every plastic surgery procedure has numerous issues that every patient who is undergoing a procedure should know. These explanations are always on a consent form that you should read in detail before surgery. This consent form, while many perceive as strictly a legal protection for the doctor, is actually more intended to improve the understanding of the earlobe repair or reconstruction procedure. The following is what Dr. Eppley discusses with his patients for this procedure. This list includes many, but not all, of the different outcomes from surgery. It should generate both a better understanding of the procedure and should answer any remaining questions that one would have.

ALTERNATIVES

There are no alternatives to surgical repair of a split or gauged (expanded) earlobe.

GOALS

The goal of earlobe repair/reconstruction is to restore the size and form of the bottom portion of the ear.

LIMITATIONS

The limitations to earlobe repair is how much natural earlobe tissue remains, whether it has any scar associated with it (e.g., keloid) and what the adjoining cartilaginous ear looks like.

EXPECTED OUTCOME

Expected outcomes include the following: temporary swelling and bruising of the ear, a temporary firmness of the reconstructed earlobe, some mild discomfort of the earlobe, and temporary redness of the incision line/scar. It may take weeks to months before the final shape and optimal appearance of the earlobe is achieved.

RISKS

Complications may include bleeding, infection, dehiscence of the incisional closure (part or complete separation), a prominent or noticeable scar, earlobe asymmetry from the other side, and a notch along the outer rim of the earlobe.

ADDITIONAL SURGERY

How the earlobe heals and the occurrence of complications can influence the final shape and appearance of the earlobe after it heals. Should complications or the desire to enhance the result further by additional surgery be needed, this will generate additional costs.

Plastic Surgery’s Did You Know? The Injury Prone Earlobe

Monday, September 24th, 2012

 

During this past Sunday’s NFL game between the Houston Texans and the Denver Broncos, Houston quarterback Matt Schaub suffered a vicious and illegal hit to the head by a blitzing Denver linebacker. Besides knocking his helmet off and flattening him on the ground, part of his earlobe was torn off. (inactuality the earlobe appears split) Witnessing this hit on TV, I can testify to the severity of the collision. This is a very uncommon football injury and is the result of the crushing impact on the helmet at intense speed on the poor little earlobe. Why did this ear injury happen this way…because of the difference in anatomy between the ear proper and the earlobe. The earlobe is the only part of the ear that does not have the structural support of internal cartilage. It is just skin and fat and is soft and structurally weak by comparison to the rest of the ear above it. This is why the earlobe can be stretched out by heavy ear ring wear and gets longer as one ages while the rest of the ear remains structurally unchanged.

Earlobe Reconstruction of the Gauged (Stretched) Earlobe

Sunday, May 31st, 2009

Earlobe repairs are often quite simple and use standard techniques for slits and tear deformities. The gauged ear, however, is a different matter.  Gauges, also known as tunnels, cogs, caps or plugs, create a considerable tissue expansion of the earlobe and require a more sophisticated approach to repair.

Younger men with gauged ears are increasingly requesting earlobe repair. This is usually so that they can enroll in the military. If not for this concern, many simply remove the earlobe device and let it shrink and contract with a resulting earlobe deformity.

Like a simple split earlobe repair, gauged ear reconstruction can be done under local anesthesia. In simplicity, the oval cleft of the earlobe is initially converted into a complete cleft by removing the remaining skin margins up to the diameter of the gauged device. The remaining inner earlobe margins (which were up against the device) are de-epithelized. The reapproximation process of the edges then begins at the apex of the cleft margins and runs outward towards the helical margin. By so doing, one can work out any excess vertical length so the repair does not look too long and pointy. A two-layer closure is done at the subcutaneous and skin layers. I prefer skin sutures that have to be removed in 7 to 10 days. No dressing is needed.

In significant ear gauges, a completely normal earlobe may not be possible to get. Usually the earlobe will be a little smaller. But I prefer a well-shaped earlobe that is smaller than one that is more normal in size but has an elongated appearance.

Dr. Barry Eppley

Indianapolis, Indiana

Earlobe Reduction – Reshaping Big Earlobes

Sunday, July 13th, 2008

The earlobe rarely gathers attention unless it is somehow deformed. Split, pierced, too small, or too big are all problems that an earlobe can have. A large earlobe is very noticeable and we all have seen someone with too large an appendage hanging from the side of their head.. Often it occurs in someone whose ear is big anyway and it is really proportionate to the size of the ear. As the patient has lived with their ears all of their lifes, it usually does not bother them. (although it might bother others) As one ages, however, some people develop longer and larger earlobes and this new development is more bothersome.
The large earlobe is not hard to reduce but the key is to do with as little scarring as possible. Unlike the split or pierced earlobe, where one can accept scarring since the earlobe is already marred, the large earlobe has no visible skin deformity. One must accept, however, the trade-off of some scarring for a smaller earlobe. The question becomes where to put that earlobe scar in reduction lobuloplasty.
There are two basic approaches….put the scar in a natural crease or put in in the middle of the earlobe. For a woman, the concern of scarring in the middle of the earlobe may be a mute point with the use of ear rings which can have a great camouflaging effect. This should be discussed beforehand. Taking a wedge out of the middle of the earlobe and putting a scar there is the best reduction method because it creates a natural-looking (but scarred) and better shaped earlobe. The earlobe can also be reduced by taking a wedge from its front part where it attachs to the side of the face. This puts the scar in that natural crease where the two join but the earlobe can end up looking a little unnatural as the earlobe now attachs directly to the face without a natural break or upsweep from the earlobe.
Earlobe reductions can easily be performed in the office under local anesthesia. But I find many earlobe reductions are done at the time of facelift surgery where two problems can be dealt with at once. It is a bit trickier to adjust an earlobe while lifting and tucking a facelift but it can be done.
Dr. Barry Eppley

Indianapolis, Indiana

Plastic Surgery Repair of the Split or Pierced Earlobe

Thursday, June 26th, 2008

The earlobes, often an after thought when thinking about the ear, is the only part of the ear that does not contain cartilage. As a result, it is much more delicate than the rest of the ear (which is supported by cartilage) and is prone to be easily torn and deformed.
Ear rings, either by their weight over time or from being accidentally (or deliberately) pulled, can easily create a complete tear resulting in a split earlobe. Sometimes the tear is not complete and a small amount of skin remains intact with a resultant very large hole. In today’s styles of ear rings, many women (and some men) have multiple holes along the earlobe. I have seen as many as five. As some women age, they desire less holes and want to revert back to a more traditional one hole centrally placed in the ear lobe.
Both ear lobe tears and ear piercing holes can be easily repaired. This is a simple office procedure done under local anesthesia. Partial or complete ear lobe tears are cut out along the torn skin and the ‘open wedge’ is closed in a straight line. I will often make a very small V at the helical margin (outer rim of skin) so that the straight line is broken up and a notch does not occur as the ear lobe heals. This V-shaped skin flap is very small (2 – 3mm) so it is not seen. Suture are used on the front and back of the ear lobe. Dissolvable sutures are used on the back of the ear so they do not have to be removed. Small removeable sutures are used in the visible front part of the ear as they cause less tissue reaction and scar better.
Ear lobe piercings are even easier to remove. Once the skin is anesthetized, a small circular skin punch is used to cut out the hole(s). In a single manuever with the punch, the full-thickness of the ear lobe hole is removed. A few skin stitches closes both sides of the ear lobe, leaving a nearly indetectable small scar.
The biggest concern of most ear lobe repair patients is that the procedure will be uncomfortable. In reality, it is painless. A very small needle is used to place a few drops of local anesthetic in front of the ear lobe. In a few minutes, the ear lobe is completely numb and the ear lobe can then be injected painlessly. One should have no fear of the ear!
Dr. Barry Eppley

Indianapolis, Indiana

Earlobe Enhancement with Injectable Fillers

Tuesday, May 27th, 2008

It is a well recognized phenomenon that as we age, our earlobes sag and ‘grow’ longer. With this sagging, some earlobes get thinner and develop creases or wrinkles as well. This is almost an exclusive female problem which is often exaggerated by the use of ear rings over the years. In those women who develop elongated ear lobe holes or have actual tears, resulting in a split ear lobe, the ear lobes are often thin as well even after surgical repair.
One of the more uncommon, but very beneficial uses of injectable fillers, is to rejuvenate the appearance of the thinned ear lobe. Adding volume to the ear lobe through an injectable filler helps expand and stretch the ear lobe out to a more youthful appearance. I prefer the use of a hyaluronic filler, such as Juvaderm, Restylane, or Perlane, to create this tissue-expanding earlobe effect. It is quick and easy to perform and a hyaluronic filler flows in quite nicely into the small space of the earlobe. A small volume of .2 to .3ccs is all that is needed per ear alobe. An injectable filler in the ear lobe seems to last much longer than in any other area of the face, presumably due to the lack of any muscle movement on the treated area. patients can wear ear rings immediately thereafter.
I would not say that the hyaluronic acid fillers in the ear lobe are permanent but volume retention up to a year is likely. I suspect that any of the particulated fillers would last much longer (years) and I will likely turn to using those instead in the near future. I don’t think they pose any increased risk in the ear lobe compared to any other facial area.
For those squeemish about putting a needle in the ear (I would be!), I always numb up the area first by doing a simple injection of local anesthetic right in front of the earlobe which is not as tender an area. Ear lobe injections are then painless!
Dr. Barry Eppley

Indianapolis,, Indiana

Repair of Torn or Split Earlobes – Easier Than You Think!

Friday, May 23rd, 2008

By far, the common ear problem that I see as a plastic surgeon is that of an earlobe problem. Whether it is damage to the earlobe from the wearing of heavy ear rings or an earlobe that has been torn due to being pulled through, the earlobe that is split in two or has an elongated hole is unsightly for many patients.
Contrary to popular perception, repair of a torn earlobe is a very simple procedure that can be done in the office under local anesthesia. The earlobe is very easy and relatively painless to get numb by placing local anesthetic in front of the earlobe first. Once the earlobe is numb, then I inject the earlobe with more local anesthetic for its ability to control any bleeding. This is quite a painless way to get an earlobe numb. Once the earlobe is numb, then a wedge along the split or elongated hole is removed and the earlobe is put back together. This requires stitches on on both the front and back of the earlobe. Other than a little antibiotic ointment, there are no dressings that are needed and once can shower and get it wet the next day. There is very little discomfort and or swelling after the procedure. The stitches are removed in a week. You can re-pierce the repaired earlobe in 6 weeks after the procedure.
Earlobe repairs can quickly and permanently repair a disfigured earlobe and make it ready to insert a new ear piercing shortly thereafter. It is not necessary to walk around with a torn earlobe out of fear that is a painful, expensive, or complicated problem to solve.
Dr. Barry Eppley

Indianapolis, Indiana


Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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