Dr. John Hilinski
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Earlobe Reshaping

Earlobe repair is a surgical procedure that is intended to correct abnormally shaped earlobes. Some plastic surgeons consider earlobe surgery to be a subset of otoplasty, or ear reshaping. In most cases, earlobe reshaping involves an earlobe that was traumatically injured – like a torn earlobe. In other cases the earlobe is reshaped because of being altered from a prior piercing or gauging. In rare cases, earlobe surgery is done to address a congenital problem that arose from birth, like excessively large earlobes.

Earlobe Laceration

Earlobe laceration repair is a very common office-based surgical procedure performed by facial plastic surgeons. Earlobes are typically lacerated, or torn, from earrings that get inadvertently pulled. They can also occur in patients who wear excessively heavy earrings that pull down on the earlobes. In many patients, the tiny hole from the piercing becomes elongated as the skin is torn. In the adjacent photo diagram, you can see this visually. This is a San Diego earlobe repair patient who presented with a torn earlobe. As you can appreciate, she has a normal earlobe piercing as indicated by the blue arrow. Immediately adjacent to this, she had another earlobe piercing that was torn from her earring being pulled down accidentally (see red curve). What once was a small pinpoint piercing is now an elongated opening in the earlobe.

In other earlobe repair patients, the laceration is significant enough to tear all the way through the lower border of the earlobe. This type of earlobe laceration is demonstrated visually in the adjacent diagram. In this type of earlobe injury, the border of the lobule has been disrupted completely. In some patients this results in an elongated separation of the skin whereas in other patients an actual wedge shaped deformity can be seen along the perimeter of the ear. In the adjacent photo example, this patient was unlucky enough to have both types of deformities arise from the laceration of the earlobe. In her case, two piercings tore at the same time resulting in her deformity.

Earlobe Gauging

Over the last several years, earlobe gauging has become a very popular and trendy practice. Purists will tell you that earlobe gauging is actually not the correct term, but most lay people are more familiar with use of this term to describe this practice. Earlobe gauging involves placement of a gauge, or plug, into the earlobe. Gradually, a larger gauge can be placed over time to further stretch the earlobe to the desired size.In the adjacent diagram you can see visually what a gauge looks like after a larger one is eventually placed. Patients who undergo repair of the earlobe following gauging have decided to stop the practice and wish to have the ear restored to a more normal shape.

Unfortunately, after stretching the earlobe to such a degree, the skin will not shrink back down on its own. This is shown in the adjacent earlobe photo, which is a patient of ours from San Diego who finally desired to have her gauge holes repaired. As you can appreciate from the photo, once the gauge is removed, the skin simply begins to hang down due to gravity. In these instances, the skin has been stretched to the point where the elasticity (rubber band quality) has been lost. Since the earlobe can no longer snap back to its original shape and size, the skin begins to droop down without the gauge in place. In essence, the remaining earlobe looks and feels like a small segment of rope looping down. Needless to say, this is something that is not desirable once the decision is made to stop wearing the earlobe gauges. Consequently, patients look to plastic surgery to help with the situation. In order to reshape the ear, a surgical procedure is required to close the opening and remove the excess soft tissue surrounding the earlobe. This type of earlobe repair is much more complicated than correction of a torn earlobe as might be expected.

Enlarged Earlobes

In some cases, patients present for earlobe reshaping because their earlobes are just too large for their liking. This is a congenital issue that they are born with and not something that arises from an injury or prior procedure. For example, the adjacent photo is of one of my patients from San Diego who thought that her earlobe was too large compared with the rest of her ear. On examination, it was noted to be slightly fuller than the average earlobe. In cases like this, plastic surgery can be performed to reduce the size of the earlobe to be more proportional with the remaining ear.

Earlobe Reshaping Surgery

Earlobe reshaping can be performed to provide a more cosmetically pleasing appearance to the ear. Depending on the type of abnormality, the surgery can vary between something that is minimally invasive to a procedure that might entail more of a recovery period.

When dealing with a simple earlobe laceration (torn earlobe), the surgical repair process can be typically performed under local anesthesia in our San Diego office. The surgery usually takes about 15-30 minutes per earlobe. The sutures (stitches) in the skin are typically removed in about 4-5 days. Pain is minimal with complete control using low dose narcotic pain medication.

When dealing with earlobes that need repair following gauging, the procedure can be a little bit more involved. This type of repair can usually take more like 20-30 minutes, but can be done under just local anesthesia in the office setting. There is much more soft tissue that requires reshaping with earlobes that have been gauged, so the sutures may be more extensive compared with repair of a torn earlobe. Despite this, the recovery process is about the same with sutures removed in 4-5 days and minimal pain overall.

Earlobe reduction surgery for enlarged earlobes is very similar in terms of the surgical effort and recovery. Earlobe reduction also takes about 15-20 minutes to complete under local anesthesia with a very similar recovery period to surgical repair of torn earlobes and gauging.

One of the most common questions we get asked regarding earlobe reshaping has to do with re-piercing of the ears following surgery. In most patients, the ears can be pierced once again in 8-12 weeks after the earlobe reshaping surgery.

To view real patient examples of earlobe reshaping surgery, including repair of torn earlobes, earlobe gauging and enlarged earlobes, please visit our online photo gallery page.

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