​​​​​​​​​​​​​鍾經略醫生【皮膚科碩士 x 美容醫學碩士】課程研究​

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Clinical Case Report: Laser-Assisted Mole Removal on Auricular Region with Scar-Minimizing Suturing

臨床案例報告：耳部墨痣的激光去除與美容縫合技術

臨床案例報告：耳部墨痣的激光去除與美容縫合技術

摘要

本案例記錄了一宗位於耳部的黑色素痣，透過二氧化碳（CO₂）雷射汽化技術進行去除，並配合精細縫合以達致最佳美容效果。此程序展示了在耳朵這類外露且解剖結構複雜的部位，結合雷射切除與美容縫合技術的有效性。

1. 術前評估

第一張照片顯示病人耳部外側有一顆單一的黑色素痣，大小約為 1.0 公分 × 1.5 公分，顏色均勻為黑色，略為隆起，邊界清晰平滑。無潰瘍、色素不均或真皮侵犯的跡象。經視診與皮膚鏡檢查後，臨床診斷為良性黑色素痣。

2. 手術過程：雷射切除與縫合

第二張照片顯示該痣已透過 CO₂ 雷射汽化技術去除。此技術以其高精準度與低熱擴散而聞名。手術於無菌門診環境下，在局部麻醉下進行。去除後的創口以 三針間斷縫合，使用細緻、可吸收的單絲縫線完成。縫合策略旨在：

減少傷口邊緣張力
保持耳部自然輪廓
降低肥厚性疤痕風險
縫線位置經過精準對齊，以確保癒合效果與外觀修復達至最佳。

3. 術後結果

第三張照片為術後追蹤所拍，顯示傷口已完全癒合，疤痕幾乎不可見。無殘留色素、肥厚或蟹足腫形成。耳部的自然曲線與皮膚質感得以保留，顯示組織重塑成功，且對周邊結構干擾極小。

討論

此案例突顯了在美容敏感區域（如耳部）進行痣去除時，結合雷射切除與美容縫合技術的優勢。耳部因皮膚薄、鄰近軟骨且高度可見，手術挑戰較大。CO₂ 雷射提供一種出血少、熱損傷低的可控切除方式。配合精細縫合，可促進快速癒合並達致優異的美容效果。

在美容醫學領域，病人期望不僅止於醫學上的清除，更包括疤痕最小化與外觀和諧的保留，因此此技術尤為重要。

結論

結合雷射與精細縫合的痣去除技術，對於耳部良性黑色素病變而言，是一種安全且效果卓越的治療方式。此方法應被視為美容皮膚外科中的首選方案之一。

Abstract

This case study documents the successful removal of a pigmented nevus located on the auricular surface using carbon dioxide (CO₂) laser vaporization followed by precision suturing. The procedure demonstrates the efficacy of combining laser excision with aesthetic wound closure techniques to achieve optimal cosmetic outcomes, particularly in exposed and anatomically complex regions such as the ear.

1. Preoperative Assessment

The initial photograph reveals a solitary pigmented lesion measuring approximately 1.0 cm × 1.5 cm, located on the outer ear. The lesion is uniformly black in color, slightly raised, and well-circumscribed with smooth borders. No signs of ulceration, irregular pigmentation, or dermal infiltration were observed. The lesion was clinically diagnosed as a benign melanocytic nevus based on visual inspection and dermatoscopic evaluation.

2. Procedure: Laser Excision and Suturing

In the second image, the lesion has been removed using CO₂ laser vaporization, a technique known for its precision and minimal thermal spread. The laser ablation was performed under local anesthesia in a sterile outpatient setting. Following vaporization, the resulting wound was sutured with three interrupted stitches using fine, absorbable monofilament sutures. The suturing technique was selected to:

Minimize tension across the wound edges
Preserve the natural contour of the ear
Reduce the risk of hypertrophic scarring
The sutures were placed with careful alignment to ensure optimal healing and aesthetic restoration.

3. Postoperative Outcome

The third photograph, taken during follow-up, shows complete wound healing with an invisible scar. No residual pigmentation, hypertrophy, or keloid formation is evident. The ear’s natural curvature and skin texture have been preserved, indicating successful tissue remodeling and minimal disruption to surrounding structures.

Discussion

This case highlights the advantages of combining laser excision with aesthetic suturing techniques in mole removal procedures, particularly in cosmetically sensitive areas. The ear presents unique challenges due to its thin dermis, cartilage proximity, and visibility. CO₂ laser vaporization offers a controlled method of lesion removal with reduced bleeding and thermal damage. When paired with meticulous suturing, it allows for rapid healing and excellent cosmetic results.

Such outcomes are especially relevant in aesthetic medicine, where patient expectations often extend beyond medical clearance to include scar minimization and preservation of anatomical harmony.

Conclusion

Laser-assisted mole removal with precision suturing is a safe and effective approach for treating benign pigmented lesions on the ear. This technique offers superior cosmetic outcomes and should be considered a preferred method in aesthetic dermatologic surgery.

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