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Steven S Greenbaum - One of the best experts on this subject based on the ideXlab platform.
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use of a deep polypropylene suture during Earlobe repair a method to provide permanent reinforcement in the prevention of recurrent Earlobe tract elongation
Dermatologic Surgery, 2005Co-Authors: Joseph F Greco, Christine S Stanko, Steven S GreenbaumAbstract:Background. Cosmetic repair of elongated or lacerated Earlobe tracts is a commonly encountered dermatologic procedure. For esthetic purposes, patients may choose to repierce the repaired lobe over the original site. Subsequent piercing within a scarred area potentially increases the risk of recurrent tract elongation secondary to the reduced tensile strength of the scar. Objective. To strengthen a damaged Earlobe by incorporating a nonabsorbable, dermal polypropylene suture during Earlobe repair. Methods. The technique is described within the text. Results. A deep polypropylene suture placed within a repaired Earlobe tract provides a permanent barrier above which repiercing can be performed. Conclusion. Permanent reinforcement of the repaired Earlobe serves to reduce the possibility of recurrent elongation of the Earlobe tract. The technique is relevant when repeat piercing is desired over the original site. JOSEPH F. GRECO, MD, CHRISTINE S. STANKO, MD, AND STEVEN S. GREENBAUM, MD, HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS.
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Use of a deep polypropylene suture during Earlobe repair: a method to provide permanent reinforcement in the prevention of recurrent Earlobe tract elongation.
Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 2005Co-Authors: Joseph F Greco, Christine S Stanko, Steven S GreenbaumAbstract:Cosmetic repair of elongated or lacerated Earlobe tracts is a commonly encountered dermatologic procedure. For esthetic purposes, patients may choose to repierce the repaired lobe over the original site. Subsequent piercing within a scarred area potentially increases the risk of recurrent tract elongation secondary to the reduced tensile strength of the scar. To strengthen a damaged Earlobe by incorporating a nonabsorbable, dermal polypropylene suture during Earlobe The technique is described within the text. A deep polypropylene suture placed within a repaired Earlobe tract provides a permanent barrier above which repiercing can be performed. Permanent reinforcement of the repaired Earlobe serves to reduce the possibility of recurrent elongation of the Earlobe tract. The technique is relevant when repeat piercing is desired over the original site.
Lalantha Amarasinghe - One of the best experts on this subject based on the ideXlab platform.
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The mystery of the split Earlobe.
Plastic and reconstructive surgery, 2004Co-Authors: Sherine S. Raveendran, Lalantha AmarasingheAbstract:The ancient art of body piercing has rejuvenated in the recent years as part of the fashion process. The ear is the most frequent body part to be pierced to wear jewelry. Split Earlobes are commonly presented to plastic surgeons and the recurrence rate is high. The etiology of the acquired split Earlobe was thought to be attributable to either trauma or heavy earrings. In this study, the authors explored the cause of the split Earlobe and recurrence after surgical repair. Twenty-five patients who were using gold earrings presented with split Earlobe and were studied, and the etiology of the condition was analyzed. A questionnaire was completed and the tissue obtained during surgical repair of the split Earlobes was submitted for histopathological studies. This group of patients was compared with 17 subjects having stretched Earlobe who were using heavy gold earrings. The control group consists of 50 subjects using gold earrings with normal Earlobes. Clinical presentation and the histological studies suggest that allergy to metals used in the earring could lead to split Earlobe. There is a difference between the split Earlobe and stretched Earlobe; the latter results from constant pull by heavy earrings. The authors present a new theory regarding the etiology of split Earlobe and recommend that avoiding the offending metal in the earring is indispensable to prevent recurrence.
Joseph F Greco - One of the best experts on this subject based on the ideXlab platform.
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use of a deep polypropylene suture during Earlobe repair a method to provide permanent reinforcement in the prevention of recurrent Earlobe tract elongation
Dermatologic Surgery, 2005Co-Authors: Joseph F Greco, Christine S Stanko, Steven S GreenbaumAbstract:Background. Cosmetic repair of elongated or lacerated Earlobe tracts is a commonly encountered dermatologic procedure. For esthetic purposes, patients may choose to repierce the repaired lobe over the original site. Subsequent piercing within a scarred area potentially increases the risk of recurrent tract elongation secondary to the reduced tensile strength of the scar. Objective. To strengthen a damaged Earlobe by incorporating a nonabsorbable, dermal polypropylene suture during Earlobe repair. Methods. The technique is described within the text. Results. A deep polypropylene suture placed within a repaired Earlobe tract provides a permanent barrier above which repiercing can be performed. Conclusion. Permanent reinforcement of the repaired Earlobe serves to reduce the possibility of recurrent elongation of the Earlobe tract. The technique is relevant when repeat piercing is desired over the original site. JOSEPH F. GRECO, MD, CHRISTINE S. STANKO, MD, AND STEVEN S. GREENBAUM, MD, HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS.
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Use of a deep polypropylene suture during Earlobe repair: a method to provide permanent reinforcement in the prevention of recurrent Earlobe tract elongation.
Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 2005Co-Authors: Joseph F Greco, Christine S Stanko, Steven S GreenbaumAbstract:Cosmetic repair of elongated or lacerated Earlobe tracts is a commonly encountered dermatologic procedure. For esthetic purposes, patients may choose to repierce the repaired lobe over the original site. Subsequent piercing within a scarred area potentially increases the risk of recurrent tract elongation secondary to the reduced tensile strength of the scar. To strengthen a damaged Earlobe by incorporating a nonabsorbable, dermal polypropylene suture during Earlobe The technique is described within the text. A deep polypropylene suture placed within a repaired Earlobe tract provides a permanent barrier above which repiercing can be performed. Permanent reinforcement of the repaired Earlobe serves to reduce the possibility of recurrent elongation of the Earlobe tract. The technique is relevant when repeat piercing is desired over the original site.
Choong Hyun Chang - One of the best experts on this subject based on the ideXlab platform.
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Earrings Embedded within Earlobe Keloids
Archives of plastic surgery, 2013Co-Authors: Ji Hae Park, Tae Hwan Park, Choong Hyun ChangAbstract:Keloids are a proliferative ailment of fibrous tissue secondary to dysregulation in various wound healing processes [1]. The diverse phenotypes and multitude of factors that trigger keloid formation have led us to propose "keloid disorder (KD)" as the identifying name for this condition and the term "keloid" to be reserved for referring to each individual skin lesion that patients have. Although benign, KD can cause aesthetic and functional problems, all of which pose a significant negative impact on the individual's quality of life. The Earlobes are frequently involved sites for keloid formation following ear piercing, with an incidence of 2.5% [2]. Earlobe keloids are a cosmetic disfigurement that are challenging to treat with a relatively high recurrence rate. The increasing trend toward cosmetic piercing and multiple ear piercing suggests that treating ear keloids will become a more frequent part of plastic surgery practice. Diverse treatment modalities have been introduced with varying degrees of success. Various studies have estimated the onset of the disorder to be between 10 and 30 years of age [3]. We have been faced with several Earlobe keloids with earrings embedded within them. A representative case is presented in Figs. 1--3.3. Without exception, the cases in the series can be classified as having a sessile-type single nodular pattern based on our novel classification (Chang-Park classification) [4]. We completely excised the keloidal tissue, adopting full thickness wedge excision, which is considered to be the optimal treatment in this morphologic type. The wounds were closed with the appropriate approximation using nylon 5-0 continuous sutures. A compressive wound dressing using hydrocolloid materials and magnets was applied [5]. Following appropriate wound management, the patients were instructed to use the magnets for 12 hours per day for 6 months until the therapy was completed. The purpose of this report is to remind the reader that earrings may be embedded in Earlobe keloids. Clinicians should keep this possibility in mind when faced with Earlobe keloids. Fig. 1 A right Earlobe keloid; sessile-type single nodular pattern based on Chang-Park classification (type II). Fig. 3 Earrings embedded within the Earlobe keloids.
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Earlobe keloids classification according to gross morphology determines proper surgical approach
Dermatologic Surgery, 2012Co-Authors: Tae Hwan Park, Sang Won Seo, June Kyu Kim, Choong Hyun ChangAbstract:Background A previous study described the outcomes of a treatment protocol using a prospective design and identified three clinical risk factors for recurrent keloids. Objective To introduce a novel classification of Earlobe keloids through a retrospective study and describe the appropriate surgical methods according to this new classification. Methods One thousand twenty-seven Earlobe keloids were treated at Kangbuk Samsung Hospital from March 2001 to February 2011. All cases were studied retrospectively and classified. Results The Earlobe keloids were classified into five groups. The frequency of Earlobe keloids in descending order were a sessile type, single nodular pattern; pedunculated type; sessile type, multinodular pattern; buried type; and mixed type. Different surgical methods were used based on the Chang-Park classification according to gross morphology, including core extirpation using a penetrating technique, standard keloidectomy, radical keloidectomy, keloidectomy with core extirpation, and a combination of these. All cases were closed primarily without skin grafting or sacrifice of the surrounding tissue. Conclusions This novel classification for Earlobe keloids can lead to a better understanding of the different types of Earlobe keloids and inform decisions regarding surgical methods.
Elvin G. Zook - One of the best experts on this subject based on the ideXlab platform.
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Surgical design and algorithm for correction of Earlobe ptosis and pseudoptosis deformity.
Plastic and reconstructive surgery, 2005Co-Authors: Arian Mowlavi, D. Garth Meldrum, Bradon J. Wilhelmi, James Kalkanis, Robert C. Russell, Elvin G. ZookAbstract:A previously described classification system for Earlobe ptosis and criterion for Earlobe pseudoptosis deformity was based on height measurements of the two Earlobe components: the free caudal segment and the attached cephalic segment. The "ideal" ear lobule free caudal segment was found to be between 1 and 5 mm (grade I ptosis), and the "ideal" attached cephalic segment was 15 mm or less. Earlobe pseudoptosis was defined by an attached cephalic segment measuring greater than 15 mm. Previous studies revealed an association between the elongated free caudal segment and increasing patient age and between the elongated attached cephalic segment and rhytidectomy. Sixteen fresh cadaver Earlobes were used to design surgical patterns that would differentially reduce the free caudal segment, the attached cephalic segment, or both. A horizontal, medially based triangular excision pattern was designed. Triangular excisions limited to the attached cephalic segment resulted in 98 +/- 5 percent reduction of excision height from the attached cephalic segment but also resulted in an unexpected 32 +/- 2 percent augmentation of the excision height in the free caudal segment. Triangular excisions limited to the free caudal segment resulted in 88 +/- 4 percent reduction of the excision height from the free caudal segment and negligible reduction of 4 +/- 4 percent of excision height in the cephalic attached segment. An algorithm for correction of Earlobe ptosis and pseudoptosis was subsequently derived and implemented in a clinical case. The authors propose that surgical treatment of patients with pseudoptosis be dependent on the ptosis grade. If the ptosis is grade I (1 to 5 mm), then excision of only the attached cephalic segment is recommended. If the ptosis is grade II or higher (more than 5 mm), then a combined attached cephalic and free caudal segment excision is recommended. In cases of isolated ptosis grade II or higher without pseudoptosis, then excision location of only the free caudal segment is recommended. The above simple algorithm and surgical designs will enable plastic surgeons to differentially correct Earlobe ptosis and pseudoptosis.
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Effect of face lift on Earlobe ptosis and pseudoptosis.
Plastic and reconstructive surgery, 2004Co-Authors: Arian Mowlavi, D. Garth Meldrum, Bradon J. Wilhelmi, Elvin G. ZookAbstract:The authors have previously described a classification system for Earlobe ptosis and established criteria for Earlobe pseudoptosis. Earlobe heights were characterized on the basis of anatomic landmarks, including the intertragal notch, the otobasion inferius (the most caudal anterior attachment of the Earlobe to the cheek skin), and the subaurale (the most caudal extension of the Earlobe free margin). The classification system was derived from Earlobe height preferences as determined by a survey of North American Caucasians and identified the ideal free caudal segment (otobasion inferius to subaurale distance) measuring 1 to 5 mm (grade I ptosis). Also, Earlobe pseudoptosis was defined by an attached cephalic segment (intertragal notch to otobasion inferius distance) measuring greater than 15 mm. In this study, the authors evaluated the effects of standard face lift surgery on Earlobe ptosis and pseudoptosis by comparing the preoperative and postoperative Earlobe height measurements from life-size photographs of 44 patients who underwent rhytidectomy performed by the senior author. The postoperative attached cephalic segment (intertragal notch to otobasion inferius distance, 12.22 +/- 0.364 mm) increased over its preoperative attached cephalic segment (intertragal notch to otobasion inferius distance, 11.10 +/- 0.406 mm) (p = 0.041). The postoperative free caudal segment (otobasion inferius to subaurale distance, 6.32 +/- 0.438 mm) demonstrated only a trend toward decreased heights when compared with the preoperative free caudal segment (otobasion inferius to subaurale distance, 7.15 +/- 0.489 mm) (p = 0.210). The incidence of pseudoptosis, defined by an attached segment (intertragal notch to otobasion inferius distance) greater than 15 mm, increased from 12.3 percent of preoperative patient Earlobes to 17.3 percent of postoperative patient Earlobes. An ideal free caudal segment (otobasion inferius to subaurale distance), defined by a range of 1 to 5 mm, was observed in only 37.0 percent of postoperative Earlobes versus 22.2 percent of preoperative Earlobes. Significant increases in the attached cephalic segments (intertragal notch to otobasion inferius distance) following rhytidectomies correlated with increased incidence of Earlobe pseudoptosis, as observed in 17.3 percent of postoperative patient Earlobes. Because the free caudal segment was negligibly affected by rhytidectomy, a majority of Earlobes (63.0 percent) demonstrated persistent nonoptimal free caudal segment heights (otobasion inferius to subaurale distance > 5 mm). Earlobe height changes can result from either age-related lobule ptosis (increase in free caudal segment) as previously described or in patients undergoing rhytidectomy (increase in attached cephalic segment). Therefore, ideal lobule distances along with the effects of aging and rhytidectomy surgery on the lobule should be discussed with patients who are seeking a more youthful facial appearance, so that the aging ear may be addressed concurrently with the aging face.
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Incidence of Earlobe ptosis and pseudoptosis in patients seeking facial rejuvenation surgery and effects of aging.
Plastic and reconstructive surgery, 2004Co-Authors: Arian Mowlavi, D. Garth Meldrum, Bradon J. Wilhelmi, Elvin G. ZookAbstract:The authors have previously described a classification system for Earlobe ptosis and have established a criterion for Earlobe pseudoptosis. Earlobe heights were characterized based on anatomic landmarks, including the intertragal notch, the otobasion inferius (the most caudal anterior attachment of the Earlobe to the cheek skin), and the subaurale (the most caudal extension of the Earlobe free margin). The classification system was derived from Earlobe height preferences as determined by a survey of North American Caucasians, and it identified the ideal free caudal lobule height range to measure 1 to 5 mm from otobasion inferius to subaurale (grade I ptosis). Also, Earlobe pseudoptosis was defined by the attached cephalic lobule height measuring an intertragal notch to otobasion inferius distance greater than 15 mm. In this study, the preoperative Earlobe height measurements of 44 patients seeking facial rejuvenation were evaluated. The average attached cephalic segment (intertragal notch to otobasion inferius distance) of patient Earlobes measured 11.10 +/- 0.46 mm, and the average free caudal segment (otobasion inferius to subaurale distance) of patient Earlobes measured 7.15 +/- 0.49 mm. Assessment of patient groups based on single-decade age differences demonstrated an increase in the free caudal segment (otobasion inferius to subaurale distance) with increasing age (p = 0.003). Assessment of patient groups based on single-decade age differences demonstrated no increase in the attached cephalic segment (intertragal notch to otobasion inferius distances) with increasing age (p = 0.281). When evaluating for the ideal otobasion inferius to subaurale distance, only 22.2 percent of Earlobes demonstrated an ideal free caudal Earlobe height (grade I ptosis). Moreover, pseudoptosis was detected in 12.3 percent of Earlobes. Finally, a majority of Earlobes demonstrated intrapatient variability, with only 16.2 percent of patients demonstrating identical attached cephalic segment (intertragal notch to otobasion inferius distances) and 37.8 percent demonstrating identical free caudal segment (otobasion inferius to subaurale distances) when compared with their contralateral ear. Plastic surgeons should be aware that a significant number of patients (77.8 percent of Earlobes) may not possess an ideal free caudal segment and that 12.3 percent of Earlobes may present with pseudoptosis. Therefore, Earlobe height assessment should be an essential aspect of evaluation in patients desiring facial rejuvenation surgery. Evaluation of both ears should be performed independently due to intrapatient Earlobe height variations. Finally, patients should be counseled with regard to the ideal Earlobe parameters and aging patterns (stable attached cephalic segment versus increasing free caudal segment). With the natural progression of both facial rhytides and caudal segment Earlobe ptosis (increasing free lobule segment) with increasing age, independent and accurate assessment of Earlobe height is indicated so that the aging ear may be addressed concurrently with the aging face.
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the aesthetic Earlobe classification of lobule ptosis on the basis of a survey of north american caucasians
Plastic and Reconstructive Surgery, 2003Co-Authors: Arian Mowlavi, Bradon J. Wilhelmi, Garth D Meldrum, Ashkan Ghavami, Elvin G. ZookAbstract:North American Caucasian male subjects (n = 59) and female subjects (n = 72) were surveyed, to investigate Earlobe height preferences that could serve as guidelines for aesthetic Earlobe surgical procedures and reconstructions. Subjects were asked to rank their preferences for variously shaped earlo
