The earlobe rarely gathers attention unless it is somehow deformed. Split, pierced, too small, or too big are all problems that an earlobe can have. A large earlobe is very noticeable and we all have seen someone with too large an appendage hanging from the side of their head.. Often it occurs in someone whose ear is big anyway and it is really proportionate to the size of the ear. As the patient has lived with their ears all of their lifes, it usually does not bother them. (although it might bother others) As one ages, however, some people develop longer and larger earlobes and this new development is more bothersome.
The large earlobe is not hard to reduce but the key is to do with as little scarring as possible. Unlike the split or pierced earlobe, where one can accept scarring since the earlobe is already marred, the large earlobe has no visible skin deformity. One must accept, however, the trade-off of some scarring for a smaller earlobe. The question becomes where to put that earlobe scar in reduction lobuloplasty.
There are two basic approaches….put the scar in a natural crease or put in in the middle of the earlobe. For a woman, the concern of scarring in the middle of the earlobe may be a mute point with the use of ear rings which can have a great camouflaging effect. This should be discussed beforehand. Taking a wedge out of the middle of the earlobe and putting a scar there is the best reduction method because it creates a natural-looking (but scarred) and better shaped earlobe. The earlobe can also be reduced by taking a wedge from its front part where it attachs to the side of the face. This puts the scar in that natural crease where the two join but the earlobe can end up looking a little unnatural as the earlobe now attachs directly to the face without a natural break or upsweep from the earlobe.
Earlobe reductions can easily be performed in the office under local anesthesia. But I find many earlobe reductions are done at the time of facelift surgery where two problems can be dealt with at once. It is a bit trickier to adjust an earlobe while lifting and tucking a facelift but it can be done.
Dr. Barry Eppley
Indianapolis, Indiana