Most causes of earlobe deformities are actually related to piercings. Wearing heavy earrings or tugging on the earrings can lead to stretching and tearing at the earlobe. Another deformity that is becoming more common is the stretching from gauges in the earlobe. Individuals with gauges in their ears are stretching the earlobes to very large proportions. When the gauges are removed, it leads to a very disfiguring deformity. If patients no longer want to wear the gauges anymore, they usually \want to repair the earlobe back to its original state. By and large, the most common cause of earlobe deformity is from the stretching and tearing of the lobe from earrings.
Some patients that have worn heavy earrings for a long period of time see pulling and weight on the earlobes that stretch them. Stretching over time, coupled with the volume loss in the earlobe, causes the earlobe tissue to simply not have the proper strength to remain intact. The earlobe skin is very delicate and thin. If there is any propensity of tearing from weakening, a little bit of trauma or pressure can easily tear the earlobe.
Earlobe deformities come in two types.
One is stretching of the earlobe where the hole where the earring resides has been enlarged and stretched.
The second type is actual tearing of the earlobe. These are the ones where the earlobe stretches so much that it ultimately leads to a tear as the earlobe skin completely succumbs to the weight of the earring.
When grading the deformities, the earlobe gauges cause more of a severe deformity because the earlobe has been stretched to such great proportions.
There are two options and they depend on the amount of volume loss in the earlobe. A lot of patients think they have a stretched earlobe but they actually have volume loss in the earlobe which is a fairly unknown concept. Sometimes when patients have lost a lot of volume in the earlobe, and they have an earring in place, the earlobe has less support and the earring will hang lower. Patients then assume they need an earlobe repair because the earring is not sittingproperly.
Oftentimes when the patient comes in, there has been no stretching or tearing. But because of the loss of volume in the earlobe itself, there is no support anymore. These patients should be treated without any surgery. They can be treated by restoring volume just like in other areas of the face with facial fillers. A fairly significant number of patients can be treated this way.
If there is an actual stretching or tearing of the earlobe, surgical repair is the only option. The surgeon would go in and remove a small part of the skin and then re-close the earlobe back to its normal anatomic state.
For an earlobe that has been completely torn, it is essentially the same type of procedure to remove that skin and then re-close and repair the earlobe with suturing. For a patient where it is stretched but not fully torn, the majority of cases involve tearing the earlobe during the procedure and then closing it all the way up. If the doctor does not actually create a full tear in the earlobe, it will often change the shape of the earlobe, and may create an undesirable shape for the earlobe.
Stretching is related to age because people lose support in the tissue as they age. There is certainly some fat loss as well out in the earlobe. The volume loss causes a weakening of the earlobe so any weight on the earlobe can lead to stretching. Plus, the heavier the earring, the more likely there will be some degree of stretching as well.
As people get older, their skin ages and loses elasticity and some of the supporting structures. The skin loses strength as well as volume.
The only major limitation is that an earlobe repair will not add any volume to the earlobe. For patients who do not have preexisting volume loss and need a repair, they often need volume added as well by using fillers. A doctor cannot make the earlobe appear to have more volume from the repair itself.
Fat can be added but, if it is just a small area, it does not make any sense unless someone wants to have a fat grafting procedure. It is much more straightforward and makes more sense to use facial fillers.
In general after any earlobe repair procedure, scarring is minimal. It is rare to have a patient concerned about the scar after the procedure. Earlobes with volume loss can sometimes have more noticeable scars because less volume means the scar might invert more. But for these patients, adding volume to the earlobe will then improve the appearance of the scar.
A successful earlobe repair allows the patient to re-pierce the ear again. Patients should wait six to eightweeks after the procedure before piercing again. The scar needs to develop sufficient strength before any piercing happens.
Earlobe keloids can be a rare complication after earlobe repair. Patients who have a history of keloid formation should be careful when undergoing ear repair just because the earlobe is a fairly common area for keloids to form. If they form a keloid, that is a much greater problem on the earlobe than a stretched or torn earlobe. There is a significant genetic component associated with keloids. Typically, patients who develop keloids will be at risk in developing on multiple sites of the body. There are areas that are more prone to keloid formation like the midline chest or the earlobes.
When it comes to recovery, earlobe repair really has no downtime. There is no true recovery period per se. The sutures that are in place tend to be removed in one week. There is potentially no pain after the procedure. Any pain or discomfort is easily controlled with Tylenol. The procedure is performed under local anesthesia by injection so patients do not feel any discomfort during or after the procedure.
They can go straight back to work as long as they do not do anything strenuous like heavy exercise for a week.
Earlobe repair may appear to be a straightforward procedure but it does require technical skill and good judgement. Patients should use a respected surgeon who has a lot of experience with this procedure specifically. There are a lot of small technical nuances that require skill and also an understanding of how the area heals to maximize the results.
Written by Cosmetic Town Editorial Team – MA
Based on an exclusive interview with Ryan Greene, MD in Weston, FL