Ever Heal?
Also Bad Looking Scar on Face Not Where Stitches Were Even Put?
I had a mini face lift about 5 weeks ago by a Plastic surgeon.
I have seen that his work is normally very good.
However, I think my ears are a mess.
I still have scabs that are not healing at the back.
I was on antibiotic cream until the 4th week and was asked to put on Hydrocortisone until
the 5th week.
I am due to see the plastic surgeon soon.
I think this is going to scar badly.
1 week after operation, a scab came in front of the ear.
The Plastic Surgeon said that this will fall off eventually and said that the scar would
be okay after 2 weeks but then, it has gotten worse since.
Do I have pixie ears and is the scar bad?
Thank you for your question!
You had a mini lift few weeks before you submitted your question and you sent some very good
photos of areas of scabbing.
And your doctor has been staying on top of this with you as far as preventing infection
with antibiotic creams as well as the use of topical hydrocortisone.
So you asked a couple of questions.
One is do you have a pixie ear and two is about whether these are going to heal badly
.
Well, first we got to understand what is likely happening as far as your healing process.
The thing about face lifting surgery is that the very edge of the skin flap, the very end
were the sutures have done along the ear, is the area that has the least amount of oxygen
or blood supply by nature of the separation of the skin.
So it's very important that proper bloody supply be there.
Now, even in patients who are non-smokers, sometimes there can be some compromise.
And so one of the things I make sure that my patients know about is to avoid smoking.
And if people who are and ofcourse in your question you didn't mention anything about
history of smoking, but just to illustrate the concept of anything that compromises the
blood supply can potentially cause the this to have stress and develop a compromising
integrity.
OKay, so what is likely the situiation is there is some compromise of the blood supply
in the skin flap and that you are dealing with this breakdown of the skin and the result
is scabbing because it's bleeding.
And so, it's very critical at the time when there is a scabbing period and there is a
compromise that we prevent any antibacterial infections.
So of course, certainly your surgeon is right on track with you.
As far as whether or not you have a pixie ear, pixie ear by definition is an earlobe
that tends to be pulled downward.
And so that's why it's called pixie ear because it looks like a little point.
And so from the photo you submitted of your left ear which looks rounded and I can't say
that you have a pixie ear.
As far as the skin healing future, I can tell you that even with some patients who are smokers
or ex-smokers who develop necrosis, where things turn black and become really compromised,
there are a lot of patients who do pretty well despite having problems with skin healing.
And there are certainly things that can be done.
In my practice, I happen to be a fortunate in having a lot of experience with the material
called extracellular matrix which we use in our incisions to help the healing process
and it heals by duplication of the normal cells so that the incision lines heal beautifully.
And in a situation like yours, it really sounds like your surgeon is right on track.
And it's basically a matter of time to see how things heal.
So I wouldn't say that your future is bleak at all I think that you should continue working
with your surgeon as far as managing these issues and make sure you avoid touching those
areas too much.
Wash your hands frequently and as soon as this all settles out, typically we would wait
at about 6 months before planning any type revisional work or any type of other interventions
to help with the cosmetic appearance.
So again, it is very good that you're protecting the skin and having close coordination with
your surgeon and wait this out and hopefully things will get better and ultimately you
should do well.
So I hope that was helpful and thank you for your question.