Fresh surgical margins following wedge excision of the earlobe defect. The preferred location is the inferior portion of the enlarged earlobe because of the superior vascular supply (Fig. If there is simply extra earlobe tissue, an incision is made along the bottom edge of the earlobe. The ear wedge is a useful repair option for excision of tumors on the helix or for a large Mohs defect, encompassing both anterior and posterior skin of the auricle with or without loss of cartilage. With ear lobe reduction surgery, a small amount of ear cartilage is removed from the lower ear. Earlobe reductions are performed when the size of the lobe becomes droopy, pendulous, or un-proportionate to the face. Typically, the wedge technique is performed on patients who have an attached earlobe. Elliptical excision. 20.26). The wedge excision may be performed on the medial, lateral, or inferior portion of the enlarged earlobe. Wedge Reconstruction of Partial Auriculectomy Defects Edward I. Chang Matthew M. Hanasono DEFINITION Partial ear defects can result following trauma or more commonly following resection of cutaneous malignancies. Earlobes can be very effectively reduced by a variety of tissue excision techniques.While many types of earlobe reductions have been described, they fundamentally come down to a wedge excision through the body of the earlobe or an elliptical excision oriented across the bottom of the earlobe. Figure 3. A large tumor on the helix is excised in a wedge shape, and the … If the lobe is very wide, a wedge-shaped incision may be necessary which creates a thin vertical scar, narrowing and shortening the overall lobe. 2. The procedure is done by marking the earlobe with a geometric … Wedge resection and closure techniques are appropriate for defects up to one-third of the outer circumference of the ear occurring in the upper two-thirds of the ear… These treatment methods are simple and effective and can be performed in … Simple interrupted sutures are placed on the surgical margins of the earlobe circumferentially. Wedge excision: This involves a vertical incision along the earlobe, leaving a vertical scar that may be more visible. Wedge excision. That soft tissue is removed and repaired. –Biopsy of external ear is 69100 –Biopsy of Lip is 40490 •All codes include a simple closure 10 Coding Lesion Excision •Skin Tags –11200 up to and including 15 lesions –+11201 each additional 10 lesions •Shaving Lesions –11300 –11313 •Please note size and location determine code selection •This does not require suture closure Contraindications. Other Procedures Are Available. This is a video which demonstrates a resection of a keloid scar from the ear lobe and reconstruction. The techniques used will depend upon your specific anatomy. The surgeon then removes a wedge of soft tissue to reduce the size of the ear lobe. The principle behind the wedge closure is the conversion of the defect into a full-thickness (anterior skin, cartilage, posterior skin) triangular wedge. It is useful for patients who are interested in simultaneous repair of a torn earlobe or who have an attached earlobe (meaning that there is no skin hanging below the ear … This means there is no hanging skin below the ear and cheek junction so it requires a smaller amount of skin excision. Each approach has its own advantages and disadvantages. This prevents the ear lobe from sticking out. This surgery is a quick, outpatient procedure that provides permanent results. Defects on most aspects of the helix can be repaired with a wedge excision (see the image below). Ideally, the inner corner of the wedge is 30° to minimize the formation of a dog ear. There is scarring, but the scars usually fade quickly in a matter of months. The use of hyaluronic acid and fat transfer for restoring ear volume, and wedge excision for earlobe reduction, offer a high level of satisfaction in patients with earlobe ptosis.

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