Earlobe Repair

Gauged Earlobe Repair

Body piercing has existed among different cultures for thousands of years. Piercings are performed so that jewelry and decorative items can be exhibited as part of self beautification and attractiveness. About 20 years ago single ear piercing became popular among men and is still considered the cool thing to do.

Gauged earlobe stretching is the gradual expansion of a simple ear piercing in order to fit in larger and larger size plugs. The excessive stretching of earlobes by expanders known as gauges causes severe thinning and distortion of the earlobe tissues. The more severe the distortion the more difficult it is to repair the gauged ear lobe simply because in severely damaged earlobe cases there just is not enough healthy tissue left to reconstruct the earlobe into a normal or near normal shape. There is no established method or technique for repairing gauged earlobes. The plastic surgeon can not study a book or an article to learn the technique. He has to rely on his plastic surgery knowledge and experience. Extensive experience in repairing traumatic ear injuries and some artistry of course helps.

I have seen an increasing number of young men and women who come to see me for repair and correction of their gauged earlobes for the past 2-3 years, whether it’s the tough job market or the stigma attached to the gauged earlobe culture, that I am not sure. I see many young men applying for a career in the United States Armed Forces who are being turned away by the recruiters. It is my understanding that not only gauged earlobes, but a simple pierced earlobe is not acceptable in the recruiting offices.

Repair and restoration of a severely distorted gauged earlobe is a complicated, tedious, precise and time consuming operation. I perform all of these cases under local anesthesia using loupe magnification. Some cases take 4 or more hours to do. Post operative discomfort is easily controlled with prescription pain medication and down time is no more than 1-2 days. Stitches are removed in one week.

Keloid Scars of Earlobe

Beverly Hills otoplasty patient before and after photos. We all know when skin is injured the body has an inborn way of healing the wound. All skin wounds usually heal even if they are left untreated unless an infection sets in or the wound is large and deep enough to involve internal organs in which case major complications can set in. Unfortunately a self healed wound usually heals poorly and leaves bad scars. In order to optimize the healing process and obtain the best possible scars the services of a well trained plastic surgeon is often required. Plastic surgeons have the training and experience of repairing wounds using fine plastic surgical techniques. Sometimes no matter how skillfully a wound is repaired, it heals poorly leaving an unsightly scar.

Keloids are raised bumpy red scars which can grow well beyond the site of the injury. Keloid scars are the result of an over exaggerated healing process and occur in some individuals and at certain areas of the body. One such area is the earlobe. Keloids can occur as a result of a simple earlobe piercing or a simple squeezing of a pimple or any minor injury to the skin. Although Keloids are more common in darker skin tones, they can occur in any skin type as some individuals have a genetic predisposition to form Keloids. Treatment of Keloids consists of careful excision followed by serial injections of diluted Cortisone. Recurrence rate is relatively high.

Earlobe Keloids are treated under local anesthesia. Healing takes about one week and there is no down time. Post repair pain is usually minimal which responds well to prescription pain medication. Stitched are removed in one week.

Earlobe Reduction

Some individuals are born with larger than average earlobes which can cause a certain degree of concern and self consciousness. I have seen individuals who are so sensitive about the size of their earlobes that they will go as far as covering their ears with their altered hair style. The technique should consider the existing discrepancy of size or asymmetry and should be modified accordingly. Creation of an even and symmetrical result is the ultimate goal. The surgeon has to preserve the natural lobe/face attachment junction in order to obtain natural looking earlobes. Previously described interfat T shaped slit is used to reduce the chances of a sunken-in repair site. The procedure takes about 1.5-2 hours. Earlobe reduction is performed under local anesthesia, there is no down time and healing takes 6-7 days. Post operative pain is slight and can be controlled easily with Tylenol or prescription pain medication.

Earlobe Shortening

Beverly Hills otoplasty patient before and after photos.Some individuals have not large or thick earlobes but long earlobes. Long and narrow earlobes can be the result of gradual stretching of the earlobe tissue under the weight of heavy earrings.

The correction involves in wedge type excision of the stretched section under local anesthesia and repair using my inverted T technique. The size and site of the piece to be resected must be accurately estimated for shape and symmetry in order to obtain natural and normal looking earlobe. The difficulty is in asymmetrically stretched and elongated earlobes which will require asymmetrical excisions to obtain symmetrical results. Over the counter pain medications are all that is required to control the slight discomfort which may be present for a couple days.

 

 


Split Earlobe Repair

Split Earlobes are usually caused by prolonged use of heavy earrings or accidental pulling and tugging on an earring by a child or during hair combing. When earrings are too heavy, ear piercings tend to stretch and elongate because the entire weight of the earring is transferred to the bottom of the ear piercing via a thin hook or clasp. As a result, a high pound to square inch force is applied to the earlobe. Stretching is either partial or full which is a complete split.

The repair has to be performed with the aid of high powered magnification and the technique has to take into account the curvature of the split surfaces, other wise the repair site will sink in and be quite visible. I have developed a technique where sutures are placed after the creation of an internal inverted T shape division of the fat. This modification has resulted in a more smooth and even scar with less chance of scar indentation.

Repair of Multiple Splits in Earlobe

Beverly Hills otoplasty patient before and after photos.I have encountered many patients whose multiple ear piercings have split when thin wired or heavy earrings have been tugged on. Repair of multiple split earlobes is no different that repairing a single split. However, if the splits are too close to one another the normal tissue bridge that is left in-between adjacent repair sites may not have good blood circulation resulting in poor healing and visible scars. In multiple split cases which are too close together I repair every other one and wait 3 months before I repair the remaining ones. Recovery time is similar to single split cases.

The procedure is done under local anesthesia and takes about 45 minutes per ear. Post operative pain is slight and is controlled by either Tylenol or prescription pain medication. There is no down time. Sutures are removed in 6-7 days.

 

 

Closure of Single or Multiple Earlobe holes

When skin is punctured, such as during an injection, as soon as the needle is pulled out the puncture hole closes and shortly after heals without a trace. When earlobes are pierced the puncture hole is kept open by inserting an earring right away so that the hole will not have a chance to close. The purpose of the earring is to keep the hole open long enough until skin from the front and the back surface of the earlobe grows into the hole and lines the internal surface of the tube with normal skin. When the cylinder or tube is completely lined with normal skin it has no chance to close. This is because raw surface will heal to raw surface but intact skin will not heal to intact skin. When it is time to close an unwanted piercing the entire skin lined tube which extends from the front surface of the earlobe to the back surface has to be removed otherwise any left over tunnel within the thickness of the earlobe may produce oil cysts. An expanding oil cyst will require additional surgery. Earlobe holes are closed under local anesthesia. There is no downtime and sutures are removed in 6 days.

Repair and closure of multiple holes is no different than closure of a single piercing hole unless the multiple holes are just too close to each other. In which case, every other one should be closed to allow for proper healing and the remaining ones should be closed a few months later for the best possible results as described in the section of multiple split closures.

Repair of Earlobes with Stretched holes

Beverly Hills otoplasty patient before and after photos.Stretching or elongation of the earlobe piercing is the result of wearing heavy earrings or an accidental pull on the earring by a child or getting caught in clothing and sometimes during hair combing.

The stretch could be large enough for studs to fall out. I have treated many patients who have lost diamond studs because of this problem. It is not a good idea to attempt to partially close a stretched hole in order to avoid a later piercing. The best technique is to completely close the stretched hole and try repiercing a few months later. The previously described internal T-slit technique also applies in this case. Unless the split is too close to the lower edge of the earlobe in which case the so called near total split is converted into a full split and the split is repaired accordingly. The operation is performed under local anesthesia. Post operative healing takes about one week and there is no downtime. The procedure takes approximately 40 minutes per ear. Over the counter pain medication is adequate to control post operative discomfort if present.

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