Today, our team got the amazing opportunity to connect with Dr. Adrian E House, MD.
Dr. House manages and operates his own practice in the San Francisco Bay Area. He is a Board-Certified, Beverly Hills trained plastic surgeon who specializes in cosmetic and functional surgery of the eyes, neck, face and nose.
We chatted with Dr. House regarding all things surgery, diving deeper into the causes of ear piercing related surgeries. Dr. House walked us through some of the surgeries he performs on a day to day basis and provided our team with profound and helpful explanations as to why someone may seek surgery related to the ear.
He dives deeper as to why he would recommend Tini Lux to his patients and the importance of choosing the safest options when it comes to foreign materials co-existing with the body. Keep reading as Dr. House discusses more about his experience as a plastic surgeon, his work with world renowned surgeon Dr. Paul Nassif, MD and more!
Hi Dr. House, thank you so much for taking the time to connect with our team! Can you first start by telling us a little bit more about yourself and your practice?Thank you for having me! I’m a facial plastic and reconstructive surgeon in the San Francisco Bay Area, meaning all of my training has been exclusively within the head and neck. So I don’t do breast work or tummy tucks or anything else. I eat sleep and breath facial plastic surgery. Whether it's cosmetic enhancements or addressing functional concerns, my goal is to provide personalized care that helps patients feel more confident and comfortable in their own skin.
Can you dive deeper into your education and training experience?
Certainly. I earned my medical degree from Boston University, where I had the opportunity to engage in various roles that fueled my passion for the field. I fell in love with the complex anatomy of the face, and was selected to instruct in the cadaver lab for the BU dental school. I then completed my surgical internship and specialized Otolaryngology – Head & Neck surgical residency at the University of California, San Francisco (UCSF). Prior to my medical education, I received my undergraduate degree from University of California, Davis, and completed a Master’s degree at Boston University with a Biomedical Engineering thesis in conjunction with The California Institute of Technology (CalTech). Throughout my training, I developed a keen interest in Facial Plastic & Reconstructive Surgery, publishing scientific manuscripts and book chapters that focused on this specialized area.
Through the American Academy of Facial Plastic and Reconstructive Surgery, I then completed a fellowship in Beverly Hills with world-renowned surgeons, Dr. Paul Nassif (from the E! show, “Botched”), and Dr. Babak Azizzadeh, focusing solely on facial plastic and reconstructive surgery.
As a facial plastic surgeon, what types of surgeries do you usually perform on a day-to-day basis? What piercing and ear-related conditions do you typically treat at your office?
In my practice, I perform a wide range of surgeries related to the eyes, neck, face, and nose, as well as addressing various cosmetic ear-related conditions. For example, I love performing otoplasty surgery, which is cosmetic procedure that is designed to improve the appearance of prominent or protruding ears. The surgery involves reshaping the ear cartilage and repositioning the ears closer to the head, resulting in a more natural and aesthetically pleasing look. I also treat problems associated with ear piercings, such as stretched earlobes, reversal of gauges, or keloid scars, and even repairing or improving the contour of the earlobe and where it attaches to the face. One such condition is called a Pixie ear deformity, which typically occurs when a facelift incision is closed under too much tension, resulting in the earlobe being pulled down and forward.
Anytime I do an earlobe repair on a patient who desires their earlobes eventually repierced, I recommend they wait at least 2 months after surgery to allow the tissue to heal, and pierce them myself in clinic. I always place a sterile, hypoallergenic piercing and instruct them to leave it in for at least 6 weeks. Tini Lux Brand has been a longtime recommendation of mine to ensure both comfort and maximal healing with minimal irritation. My patients have always also loved the wide range of style selections you carry.
When would you recommend that a patient get surgery on their earlobe or ear? Are there specific qualifications that a patient needs to meet in order to receive ear-related surgery?
The decision to recommend surgery on the earlobe or ear is highly individualized and depends on various factors. In the case of stretched earlobes or significant damage to the ear, I typically recommend surgical intervention since once the tissue is stretched and/or scarred, it will never return to normal without surgical repair. However, each patient's situation is unique, and during the consultation, we assess their specific concerns, goals, and overall health to determine the most suitable approach. There are no strict qualifications, but a thorough evaluation helps ensure that the patient is well-informed and the procedure aligns with their expectations. As long as they are overall healthy and don’t have any underlying bleeding disorders, uncontrolled diabetes, or other factors that could contribute to poor wound healing, most patients are surgical candidates.
As far as timing of surgery, a couple factors are important. The first is sun exposure. The UV rays from the sun can cause hyperpigmentation of the scar, so it is critical to avoid direct sun exposure, wear a large brim hat outdoors, and apply plenty of sunscreen. I have all of my patients use a silicone scar gel after the sutures are removed that has sunscreen built into this to help with healing. So if a patient is planning a trip to Mexico or Hawaii, for example, then I advise they wait until they are back to undergo an earlobe repair. The second issue is avoiding wearing heavy earrings for at least 3 months after surgery. I have a patient who is getting married in India, so we coordinated her repair so she had plenty of time before needing to wear the traditional heavy earrings for her Indian wedding.
When performing ear and piercing-related surgeries, what are the potential complications or risks? What does the recovery and healing time look like for those types of surgeries?
Like any surgical procedure, there are potential risks and complications associated with ear and piercing-related surgeries. These can include infection, scarring, dehiscence or opening of the incision, or need for revisions if the healing process doesn’t go as planned. With proper pre-operative assessment, meticulous surgical technique, and post-operative care, I strive to minimize these risks for my patients. Recovery and healing time vary depending on the specific procedure performed, the individual patient, and their unique healing process. We provide detailed post-operative instructions and follow-up care to optimize the recovery journey and ensure the best possible outcomes. But for the most part, any earlobe surgery takes about 6-8 weeks for the initial healing process to complete and for all the swelling and any irregularities to settle out.
When patients come to you with ear piercing-related problems such as stretched earlobes or keloid scar removal, what forms of treatment would you typically recommend? Are there other treatment options besides surgery that you suggest?
Treatment options for ear piercing-related problems are determined on a case-by-case basis. For stretched earlobes, I often recommend surgical repair to restore their natural appearance. In cases involving keloid scars, surgical excision or other scar revision techniques may be considered. However, I always explore non-surgical options as well, based on the patient's specific situation and preferences. These may include specialized creams or non-invasive procedures that can complement the surgical approach, aiming for the best possible outcome while considering the patient's individual needs. For keloids for example, if they are relatively small, I tend to start with a steroid injection called Kenalog. It helps shrink the keloid scar and sometimes repeated injections are all that is needed for the patient to be happy with the appearance.
Another issue with the earlobes is volume loss with ago, also known as lobular atrophy. The earlobes consist of skin and fatty tissue. Over time, the aging process and other factors can lead to the loss of fat and collagen in the earlobes, resulting in a deflated or sagging appearance. This can also be caused by constantly wearing heavy earrings or large gauges over an extended period, which can cause stretching and thinning of the earlobe tissue, leading to volume loss.
There are also certain genetic factors that contribute. Fillers are a great way to treat this. I use the same filler that I do for lips, so it keeps the soft contour of the earlobe. This type of filler contains hyaluronic acid, a natural substance found in the skin, can be used to restore volume nicely. It is quick and minimally invasive, with little to no downtime. I also love fat transfer to the earlobe. I harvest fat from the abdomen or flanks and inject it into the earlobes to restore volume. This technique provides natural and long-lasting results, as the transferred fat integrates with the existing tissues. It is basically a permanent filler. After either of these treatments, it is key to avoid further volume loss and thinning, so I talk to my patients about wearing lighter earrings and avoiding constant pressure on the earlobes. Additionally, using hypoallergenic earrings and practicing proper earlobe care can help maintain healthy ear tissue.
Injections, surgery, and piercings all involve foreign objects or materials entering the body. Can you discuss the importance of choosing the safest materials for each procedure?
It is crucial to prioritize patient safety and well-being by choosing the safest materials. High-quality, hypoallergenic materials should always be selected to minimize the risk of adverse reactions, infections, or complications. With Tini Lux as my go-to brand, the hypoallergenic and nickel-free earrings align perfectly with my philosophy on treating your earlobes well. I always use hyaluronic acid fillers as I mentioned instead of silicone or calcium-based fillers because of how safe they are. And they are reversible if the patient for some reason doesn’t love how they look, although I’ve never had to dissolve earlobe filler so far.
In surgery, there are so many kinds of suture to choose from. By I avoid using any dissolvable suture material, even thought they are so convenient. The mechanism for the breakdown of dissolvable suture is inflammation, which can affect how well the scar heals. Anytime an incision is made, a scar forms. My job as a plastic surgeon is to minimize the appearance of it as much as possible. So I use removable sutures of the smallest caliber, either Prolene or Nylon, which are thinner than a human hair. That way the scars left behind are minimal.
What are the potential risks associated with not treating a piercing-related infection? What are ways to avoid infections from ear piercings?
Not treating a piercing-related infection can lead to serious complications. These may include abscess formation, further tissue damage of even the cartilage, or the spread of infection to surrounding areas. It's crucial to emphasize the importance of prompt treatment and follow-up care to address infections effectively. To avoid infections from ear piercings, it's vital to adhere to proper aftercare instructions provided by professional piercers or healthcare providers. This includes regular cleaning, using sterile techniques, and avoiding contact with unclean hands or objects. The last thing you want is to have skin or cartilage loss, and need skin grafting from other parts of the body to repair it. While it works, it will never look and feel like a normal earlobe once this occurs.
What is the most common cause of ear piercing-related surgeries? Why do you recommend Tini Lux to your patients?
The most common cause can vary depending on the individual patient's needs and concerns. From my experience, addressing stretched earlobes or repairing damaged ear piercings tends to be prevalent. In these cases, I prioritize patient comfort, safety, and long-term satisfaction. That's why I recommend Tini Lux to my patients. The hypoallergenic and nickel-free earrings not only minimize the risk of adverse reactions but offer a wide range of stylish options. With Tini Lux, my patients can enjoy beautiful earrings without compromising their comfort or skin health.
Can you tell us more about the Walk-A-Mile-In-My-Shoes Program and your work with the Global Smile Foundation?
Absolutely! The Walk-A-Mile-In-My-Shoes Program is a charitable initiative I co-founded in 2009. Our mission is to bring donated shoes and clothing to impoverished communities in Belize City and Ambergris Caye, Belize. Collaborating with dedicated individuals and organizations, we completed numerous trips, delivering these essential items to local families and businesses in need. It's incredibly humbling and fulfilling to witness the positive impact we can create by providing such basic necessities.
Additionally, I've been fortunate to work with the Global Smile Foundation, an organization committed to providing comprehensive cleft care for underserved populations worldwide. Through their missions, we have had the opportunity to perform life-changing surgeries and provide support to patients affected by cleft lip and palate malformations. Being able to make a difference in these individuals' lives and contribute to their overall well-being is truly rewarding. I highly recommend donating to their cause — your generosity makes a direct impact on the lives of these patients.
If you were not a plastic surgeon, what other profession could you see yourself in? What would you say is the most fulfilling aspect of your career?
I could envision myself pursuing a career in mechanical engineer and device design, and of course teaching. The opportunity to contribute to scientific advancements and educate future generations of healthcare professionals is so rewarding. However, the most fulfilling aspect of my career as a plastic surgeon is the direct impact I have on my patients' lives. Witnessing the transformations, both physical and emotional, that they experience is extraordinary. From helping individuals regain their self-confidence to improving their overall well-being, being able to positively impact their lives is a privilege that I cherish deeply. It is the driving force behind my dedication and passion for what I do.
I appreciate the opportunity to share my experiences and insights with you. If there are any further questions or topics you would like to discuss, please feel free to ask.