The earlobes are the lowest part of the ears made of skin and a small amount of fatty tissue in between. There are large variations in size, form, and shape. The earlobes serve women (and men) as popular locations for placing jewellery. Often, the earlobes are pierced to ﬁt various forms of ear ornaments ranging from studs to earrings which can occasionally set them up for trouble.
Excessive weight or trauma can easily overcome the strength of the earlobe tissues leading to a tear, which if complete, results in a split ear. Some people with rather thin earlobes who favour wearing heavy earrings, experience a gradual elongation of the ear-piercing tract such that it becomes slit-like and often too large. Another problem is that the earlobes can be torn by accidental trauma. This split may be unattractive and renders the earlobe unusable for most jewellery. Sometimes, clip-on earrings can still be ﬁtted and are used to camouﬂage the earlobe tear.
The repair of torn earlobes is relatively simple. The procedure is routinely performed in the oﬃce under local anaesthesia with an optional sedative. After planning and marking, a small amount of lignocaine numbing solution is deposited. I favour a three-layer repair done under loupe magniﬁcation. But it is very important to remove the damaged ear-piercing tract or to trim the edges of the split if the earlobe has been torn through completely.
Then the three-layer closure consists of closing the outer layer of skin, the fatty tissue between the two layers of the skin and ﬁnally the skin in the back of the earlobe. Typically, the surgeon must take great pains to avoid any notching at the bottom of the earlobe. The ﬁne sutures on the skin are usually removed within 7 days. Small amounts of antibiotic ointment are applied at home for a few days ensuring cleanliness. The healed earlobe has usually a barely visible pencil-ﬁne straight or zigzag scar line.
People often ask if the ears can be pierced again. They can but typically you should wait three months after the earlobe has been repaired. Preferably piercing should not be done within the scar, as this can stretch and inevitably result in another clot.
Thanks for reading!
Dr. Tim – Sydney Cosmetic Plastic Surgeon