The occurrence of earlobe deformities is extensive and growing rapidly. I have identified FIVE different classes of deformities, several of which are very prevalent and the numbers increasing. This is due to many patients undergoing guage and peg earlobe jewelry and, secondly, all of the poorly done facelifts that created a “pixie” earlobe which is pulled down and stretched and abnormal. Other conditions are less frequent.
The major lesson I want to teach patients is to BE CAREFUL in choosing your repair and the physician to perform this and the procedure and method chosen. My experience is that many repairs will close the holes or repair the cleft but then create an abnormal pointed long earlobe or flat broad almost non-existent earlobe. For example, many doctors will perform a surgery that allows big circular holes to heal without stitches and this creates wrinkles and scars that last forever.
I cannot overemphasize the importance of understanding the problem and your deformity and being careful to be clear about the incisions and repair from your doctor. My method is to take pictures, create a photoshop “image” of what to expect and diagram the incisions and how you will heal.
The procedure is done in the office setting under a local anesthetic and is completely comfortable and pain free. You only feel a bit of pressure. I perform this with magnifying glasses to be able to see even the smallest incision. The surgery takes about 1-2 hours and is very technical. There are no bandages and no bruising. Tiny stitches are removed in 4-5 days. You can begin exercise and vigorous activity then. You can shower the day after surgery. You will see your result right away and very minimal swelling. You can have ears re-pierced, and I like to wait about 6 weeks.
Deformities are due to:
- Earrings. Over time these may stretch the piercing holes and studs fall out. The holes may be elongated. These long slits may be harder to repair than just a complete cleft. At times, especially with a trauma, the earring may pull completely through the earlobe creating a cleft. This can be repaired. But be careful, I often see patients after a repair of a cleft that have an “indent” at the bottom of the earlobe where the repair was done not well.
- Gauges and pegs. This is the second most common source of earlobe deformities and the most severe and difficult. Here is where I most STRONGLY recommend careful choice of your doctor and procedure, especially after removal of large gauges. There is a large hole and lot of loose tissue. This requires the utmost of plastic surgery creative and artistic closure and IS NOT just making a hole into a straight line scar as this ALWAYS creates a long pointy earlobe or a short flat [absent] earlobe and both are very difficult to fix. Repair usually involves careul incisions, removal of excess tissue, and folding and molding the remaining tissue to create an earlobe of correct length, curvature, and width.
- Facelift. Many patients come to me after facelift by other doctors with a very common what we call “pixie” earlobe meaning it is stretched, pulled down into the incision at the earlobe pointed and long and thin. It looks absolutely abnormal. This requires a significant repair that involves not only the earlobe but the facelift scar and maybe more.
- Congenital. Some patients are born with a long hanging earlobe. This can be repaired and made to look normal in its length, width, curvature and fullness.
- Surgical deformity. I see this often where a patient has had a repair done poorly and creates the condition noted above of a long pointy earlobe or a flat broad earlobe or an earlobe without the normal gentle curvature or an earlobe that is flat and thin. These require significant revision surgery but can always be made better.
