The earlobe is most commonly recognized for its ability to retain a variety of different ornaments. Whether it be a piercing or a clip-on ear ring, the relatively small earlobe usually holds up well to support the weight of jewelry. But the earlobe is a rather delicate structure and is the weakest component of one’s ear. Because it lacks any cartilage like the rest of the ear, heavy ear rings or inadvertent pulling on a dangling ear ring can cause a tear or split ear lobe deformity.

The vast majority of split or near-split earlobes are vertical in orientation and singular in number. This is because most people only place one ear ring in the lobe. While some have multiple piercings, they usually are placed higher up along the helical rim away from the ear lobe proper. This is likely because of a spacing issue for the piercings but is also wise biologically due to the thin tissue of the earlobe and blood supply concerns.

When double piercings are placed directly into the earlobe, the split that can develop will be double in nature. A double-split ear lobe creates what I call the M-split earlobe deformity. The central nubbin of tissue between the splits shortens and the ear lobe has the outline of the letter M.

This rare M-split earlobe poses some small challenges in reconstruction. Do you keep the central island of skin between the splits, creating a final Y-shape scar in the earlobe when it is put back together? Or do you remove the central skin segment creating the more typical single vertical line scar albeit it longer due to the need to remove the bunching above it. While these are seemingly minor issues, one may not think so if it were their earlobe.

By keeping the central skin island and the Y-shaped scar, the size and shape of the earlobe will be kept normal. Discarding the middle tissue island of the M-split and closing as a single vertical line can make the earlobe smaller. As usual, either choice has its tradeoffs.

Using the basic plastic surgery principle of…it is better to leave too much than too little since it is easier to remove than replace…preserving the central island of skin seems best. This keeps the earlobe shape and size that once existed and the scar usually turns out very acceptably. In the advent that the scar healing is unacceptable, a secondary revision can be done to then remove the scar and central island of tissue, making a single vertical scar line.

The uncommon M-split earlobe deformity is caused by the unwise decision to place two piercings in the unsupported soft tissue of the earlobe. Double earlobe piercings increase the risk of vertical tissue splits. Its earlobe reconstruction is best initially approached by central island preservation which keeps a more normal earlobe appearance.

Dr. Barry Eppley

http://www.eppleyplasticsurgery.com

Indianapolis, Indiana

Earlobes in females are almost always adorned with either ear rings or stud wear for much of their life. Since the earlobe is the part of the ear that has no cartilage, any weight on the earlobe  must be borne by the skin and the little bit of fat that lies between the front and back skin edges. This relatively flimsy bit of earlobe tissue is not too resistant to the prolonged wearing of heavy earrings or an inadvertent tug on a tangling earring. As a result, completely split earlobes or an elongated earlobe hole are very common ear problems that present in my Indianapolis plastic surgery practice. Most of what are seen are longstanding earlobe deformities that have gotten progressively worse.

The split earlobe repair is a simple office procedure that is done under local anesthesia. It is a complete excision and vertical closure of either a partial or complete earlobe tear. There is no downtime and one can resume normal activities immediately. The conventional wisdom is that that once the earlobe is repaired, it can be re-pierced again six to eight weeks later. I have used this approach throughout my entire practice and have yet to have a patient who has come back with a failure of the repair. Some plastic surgeons feel, however, that the earlobe cannot tolerate earring wear again because it will be forever be weak and recommend more complicated types of earlobe procedures. I find these rarely necessary.

One concern that some earlobe repair patients have is the time period until they can wear their earrings again. The split earlobe repair can be done so that the wearing of a stud earring can be done immediately. As part of the upper portion of the vertical earlobe closure, a small skin flap is raised from the inside of the split and rolled upward and closed. This recreates the bottom portion of the earlobe hole with fully lined skin. The remainder of the earlobe split is closed vertically as normal. The ear stud is put in at the end of the procedure. It can be taken in and out after surgery as desired.

Split earlobe repairs can be done with either a delayed re-piercing or can be designed to allow immediate stud insertion…but not immediate heavy or dangling earring wear.

Barry L. Eppley, M.D., D.M.D.

http://www.eppleyplasticsurgery.com

http://www.ologyspa.com

Clarian North Medical Center, Carmel, Indiana

Clarian West Medical Center, Avon, Indiana

Indianapolis

Torn or split earlobes are a very common female ear problem. (and increasingly so in men also) Almos always the cause is ear rings. Whether the weight of them with time causes a near split or having someone pull on one resulting in a laceration, a bifurcated earlobe is often the result. Many people walk around with this problem fearing that a corrective procedure is painful, expensive, or both.

In reality, an earlobe repair is quite simple and relatively inexpensive. In my Indianapolis plastic surgery practice, I perform it as an office procedure under local anesthesia. The split edges are freshened up and a linear (or staggered for some) line of closure is done. Sutures are placed on both the front and backside of the earlobe. There are no other dressings. One can perform any activity after and freely get it wet in the shower or pool the next day. There may be some mild swelling of the earlobe and the fine sutures are slightly visible. Sutures are removed in 7 to 10 days whenever it is convenient for the patient. The critical question (which is always asked) of re-piercing the ears can be done again 6 weeks after the repair.

Repair of torn earlobes is a simple, uncomplicated and very effective procedure. A fine line scar will be left from the new/old hole down to the rim of the earlobe but this will be obscured by new earrings. At the cost of a few hundred dollars per ear, a reconstructed and functional earlobe can be recreated.

Dr. Barry Eppley

http://www.eppleyplasticsurgery.com

http://www.ologyspa.com

Clarian North Medical Center, Carmel, Indiana

Clarian West Medical Center, Avon, Indiana

Indianapolis

The wearing of ear jewelry has been done for thousands of years to enhance one’s appearance. Rings, posts, and other objects have been used for ear ornaments and they are as popular today as they have ever been in history. While various parts of the ear are pierced, the earlobe is the most universal site. Unfortunately the earlobe has no structural support because it contains no cartilage unlike the rest of the ear. As a result, the weight of large ear rings or trauma can pull them through the earlobe, leaving a tear or notch in the otherwise smooth continuous edge of the earlobe. The split earlobe not only causes an obvious cosmetic deformity which is hard to cover but also makes it difficult to continue to wear any ear jewelry.

Repair of the split earlobe is a common procedure that is easily done in the office at a low cost. In some cases, the ear lobe hole is merely enlarged (and almost torn through) but most cases have a complete tear creating an inverted V look. Depending on the earlobe problem, reconstruction can take different forms. In every method used, however, the skin lining the hole or tear is removed creating fresh new skin edges from to rebuild.

There are numerous minor variations to earlobe repairs, all with the intent of leaving the earlobe with a smooth and non-notched outer skin border. Whether it be a straight-line closure, z-plasty, rim w-plasty, or jelly-roll technique, they all can work successfully if done well. Over the years, I have found that the straight-line closure will work in most cases. The fear of a notched earlobe rim has not been borne out in my experience. The key is to do a complete resection of all skin edges of the tear so that a tension-free closure can be done.

After an earlobe repair, there are some small sutures that I will need to remove in a week. There are no dressings or special care that needs to be done after. One can shower and get the ear wet as normal. There is virtually no pain after and only a very mild amount of swelling.

Repair of the torn or split earlobe is a simple plastic surgery procedure that works well. One should not avoid having it done for fear that it is a big involved ordeal….for it is not.

Dr. Barry Eppley

http://www.eppleyplasticsurgery.com

http://www.ologyspa.com

Clarian North Medical Center, Carmel, Indiana

Clarian West Medical Center, Avon, Indiana

Indianapolis