Dr. Barber

Q. A few years ago I had a facelift. Most everything went well except where the facelift scar went into my hair in the temple area. I now have a bald spot about the size of a nickel, but only on one side. It is not that noticeable except when my hair is wet. Is there anything that can be done to get hair to grow back? My plastic surgeon basically told me that it is not noticeable and not to worry about it. 

A. It is not unheard of to have some loss of hair in the temple area after a facelift. The hair loss is generally due to tension caused by the pulling of the skin when doing the lifting of the face. If the tension at the incision is significant enough, it can reduce the circulation of blood to the skin around the incision. Hair follicles are very sensitive to reduced blood flow and can result in the hair bulb, where the hair grows, dying. This leads to a bald spot. It is very unlikely that the hair will ever grow back since it has been so long since surgery. You have three choices as I see it. Option one is to do as your plastic surgeon said, get over it. Obviously that choice does not sit well with you otherwise you would not have asked this question. Option two, which is the simplest, is to surgically excise the bald spot, which brings the hair back together again. This can be slightly risky in that if the incision is closed under any tension, the circulation can again be reduced and the surrounding hair bulbs can be traumatized, and baldness can occur again. Basically, this option is only viable if the size of the bald spot is fairly small. The third option is to do a hair transplant into the bald spot. Since the spot is only the size of a nickel, it would be a fairly quick procedure to fill in the missing hair follicles. Often times, it can take more than one sitting to get the bald area completely filled in. The hair transplant option will likely give the most aesthetic result.   

Q. The hole in my earlobe where my earring sits has gotten progressively larger over the years. My earring now does not sit nicely against the earlobe but hangs down. Can the hole in the earlobe be made small again?

A. Yes, it can. It requires a small surgical procedure to remove the enlarged hole and suture the skin back together again. The repaired earlobe hole is allowed to heal for about three months, then the lobe can be re-pierced. The procedure is performed under local anesthesia and has no down time after the repair. The key in the future after re-piercing is to not wear heavy earrings that pull on the hole causing it to elongate again. 

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