The patient presented with a large keloid on the ear, which had developed at the site of a previous ear piercing. The lesion was a smooth, dome-shaped mass projecting prominently from the lobule — significantly larger than the original piercing site, firm to palpation, and cosmetically distressing. Treatment was surgical excision of the keloid with carefully planned closure to recreate a natural ear-lobule contour, followed by post-operative measures to reduce the risk of keloid recurrence. The photograph taken one month later shows a fully healed lobule with only a fine residual scar — the bulk of the keloid is gone and ear shape is restored. Performed by Dr. Pongsak, Pongsak Clinic, Hua Hin.