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The earlobes, often an after thought when thinking about the ear, is the only part of the ear that does not contain cartilage. As a result, it is much more delicate than the rest of the ear (which is supported by cartilage) and is prone to be easily torn and deformed.
Ear rings, either by their weight over time or from being accidentally (or deliberately) pulled, can easily create a complete tear resulting in a split earlobe. Sometimes the tear is not complete and a small amount of skin remains intact with a resultant very large hole. In today’s styles of ear rings, many women (and some men) have multiple holes along the earlobe. I have seen as many as five. As some women age, they desire less holes and want to revert back to a more traditional one hole centrally placed in the ear lobe.
Both ear lobe tears and ear piercing holes can be easily repaired. This is a simple office procedure done under local anesthesia. Partial or complete ear lobe tears are cut out along the torn skin and the ‘open wedge’ is closed in a straight line. I will often make a very small V at the helical margin (outer rim of skin) so that the straight line is broken up and a notch does not occur as the ear lobe heals. This V-shaped skin flap is very small (2 - 3mm) so it is not seen. Suture are used on the front and back of the ear lobe. Dissolvable sutures are used on the back of the ear so they do not have to be removed. Small removeable sutures are used in the visible front part of the ear as they cause less tissue reaction and scar better.
Ear lobe piercings are even easier to remove. Once the skin is anesthetized, a small circular skin punch is used to cut out the hole(s). In a single manuever with the punch, the full-thickness of the ear lobe hole is removed. A few skin stitches closes both sides of the ear lobe, leaving a nearly indetectable small scar.
The biggest concern of most ear lobe repair patients is that the procedure will be uncomfortable. In reality, it is painless. A very small needle is used to place a few drops of local anesthetic in front of the ear lobe. In a few minutes, the ear lobe is completely numb and the ear lobe can then be injected painlessly. One should have no fear of the ear!
Dr. Barry Eppley
http://www.eppleyplasticsurgery.com
http://www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis

It is a well recognized phenomenon that as we age, our earlobes sag and ‘grow’ longer. With this sagging, some earlobes get thinner and develop creases or wrinkles as well. This is almost an exclusive female problem which is often exaggerated by the use of ear rings over the years. In those women who develop elongated ear lobe holes or have actual tears, resulting in a split ear lobe, the ear lobes are often thin as well even after surgical repair.
One of the more uncommon, but very beneficial uses of injectable fillers, is to rejuvenate the appearance of the thinned ear lobe. Adding volume to the ear lobe through an injectable filler helps expand and stretch the ear lobe out to a more youthful appearance. I prefer the use of a hyaluronic filler, such as Juvaderm, Restylane, or Perlane, to create this tissue-expanding earlobe effect. It is quick and easy to perform and a hyaluronic filler flows in quite nicely into the small space of the earlobe. A small volume of .2 to .3ccs is all that is needed per ear alobe. An injectable filler in the ear lobe seems to last much longer than in any other area of the face, presumably due to the lack of any muscle movement on the treated area. patients can wear ear rings immediately thereafter.
I would not say that the hyaluronic acid fillers in the ear lobe are permanent but volume retention up to a year is likely. I suspect that any of the particulated fillers would last much longer (years) and I will likely turn to using those instead in the near future. I don’t think they pose any increased risk in the ear lobe compared to any other facial area.
For those squeemish about putting a needle in the ear (I would be!), I always numb up the area first by doing a simple injection of local anesthetic right in front of the earlobe which is not as tender an area. Ear lobe injections are then painless!
Dr. Barry Eppley
http://www.eppleyplasticsurgery.com
http://www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis

By far, the common ear problem that I see as a plastic surgeon is that of an earlobe problem. Whether it is damage to the earlobe from the wearing of heavy ear rings or an earlobe that has been torn due to being pulled through, the earlobe that is split in two or has an elongated hole is unsightly for many patients.
Contrary to popular perception, repair of a torn earlobe is a very simple procedure that can be done in the office under local anesthesia. The earlobe is very easy and relatively painless to get numb by placing local anesthetic in front of the earlobe first. Once the earlobe is numb, then I inject the earlobe with more local anesthetic for its ability to control any bleeding. This is quite a painless way to get an earlobe numb. Once the earlobe is numb, then a wedge along the split or elongated hole is removed and the earlobe is put back together. This requires stitches on on both the front and back of the earlobe. Other than a little antibiotic ointment, there are no dressings that are needed and once can shower and get it wet the next day. There is very little discomfort and or swelling after the procedure. The stitches are removed in a week. You can re-pierce the repaired earlobe in 6 weeks after the procedure.
Earlobe repairs can quickly and permanently repair a disfigured earlobe and make it ready to insert a new ear piercing shortly thereafter. It is not necessary to walk around with a torn earlobe out of fear that is a painful, expensive, or complicated problem to solve.
Dr. Barry Eppley
http://www.eppleyplasticsurgery.com
http://www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis