Procedure Description: Unfortunately, significant weight or trauma can pull through tissue of the earlobe. A tear in the lobe or margin leaves a notch in the otherwise smooth continuous edge. This defect is usually very visible and hard to cover.
Depending on the deformity, reconstruction can take different forms. In all methods, the skin lining the slot is removed creating a raw edge to rebuild. Lost tissue complicates matters and reconstruction centers around reestablishing normal proportions in a somewhat smaller ear.
Technique 1 (layered closure): The raw edges are brought directly together using a combination of dissolvable sutures in the deeper layers and skin sutures that are removed at a later date. No provision for the jewelry hole is made at this time. After several months of healing, the ear can be pierced again if desired. A straight closure like this has increased risk of scar contraction causing a notch at the bottom of the lobe after healing.
Technique 2 ("Z-plasty" flap): Tissue cut in a special pattern and moved with its blood supply is called a flap. Flaps are used to redistribute tissue and sculpt the shape of the ear. Flaps lessen the chance of scar notching. If you want, the ear could be pierced at a later date.
Technique 3 (Jelly roll flap): A series of flaps are designed and moved to rebuild both the skin hole for the jewelry and close the ear in one stage.
Length of Procedure: Ear lobe repair surgery is a quick procedure, generally taking about half an hour, and it is performed under local anesthesia.
Recovery: You will need to wash your wound with soap and water three (3) times a day. A thin layer of antibiotic ointment is the only dressing in most cases. You may wash your hair but will have to be careful with blow dryers until sensation returns. (You could burn yourself without knowing it if you were still numb.) Expect a little drainage from the wound. Be careful of your good bed linens with the drainage and ointment. Sutures are removed in about seven (7) days.
Be careful not to have your ear re-pierced in the scar or just above the scar. The scar is weaker than the surrounding tissue so it will tear more easily. Have the new piercing done to the right or left of the scar.
Risks: All surgical procedures have some degree of risk. Major complications are unusual.
Results: The results is an earlobe that is repaired, and the scar from this procedure is almost always imperceptible. Heavier jewelry is not recommended after surgery, but if you must, wait at least two months after surgery to wear earrings. Clip on earrings may be worn six weeks after surgery. All the above time periods may need to be delayed if you still have sensitivity at the surgical site.
Estimated Cost: Average costs for a typical repair range $450 to $650 per ear which includes local anesthesia and typical operating room supplies.
