The patient presented with a small lobulated keloid on the helical rim of the upper auricle, approximately 1 cm in diameter. Older healed piercings were present on the lobule below, indicating prior earring use, with this lesion likely arising from a previous helical piercing. The lesion was removed by complete excision under local anaesthesia, with the helical perichondrium re-approximated and the skin closed in layers using fine non-absorbable sutures aligned along the rim. The follow-up image was taken immediately post-procedure, showing precise wound apposition and meticulous suture placement along the new scar line. Final aesthetic result requires several months of soft-tissue maturation. Performed by Dr. Pongsak at Pongsak Clinic, Hua Hin Road 55.