Monday, May 4, 2009

Torn Earlobe Repair

 Updated 3/2017-- photos and all links removed as many are no longer active and it's easier than checking each one.

Early in my blog life, I did an article on torn earlobe repair.  As I mentioned then, I had not figured out how to put sketches in my posts.  Over the past two years, I have learned how to add them, so am redoing the post with sketches.  I hope they help.

Torn earlobes is a complication of pierced earlobes.  Some preventive tips include:
  • Not wearing heavy ear rings.
  • Being careful when putting on or removing clothing so as not to "catch" the earring.
  • Being careful around babies/toddlers who want to play with shiny/dangling objects can help prevent the lobe from being torn.
  • Use the "earlobe support" which is a stick-on disc that help support the earlobe when heavy earrings are worn.
 Once the stretching occurs or the tear is completed, then the only way to fix it is to repair it. For me, this is an office procedure done using a simple local block.  I mix 0.5% Xylocaine with Epi and 0.25% Marcaine without Epi. 
There are variations on "how" this is done, but they all require excising (freshing) the edges so they can be sewn back together. The variations are mainly in how the excision is structured–straight, z-plastied, or L-shaped. 

I do not think the straight excision is the best way to do the repair. If the scar "shortens" at all (as straight scars are prone to do), then the lobe is "gathered" up and ends up "W" shaped at the bottom. Another reason is that unless you (the patient) are very good at repositioning the new hole to the side (either) of the scar (which is weaker by at least 20% of the surrounding skin), the tear is very likely to re-occur as the earrings pull-through the scar over time.
The Z-plasy or L-shaped scar avoid the "W" by changing the scar into a non-straight scar. Which one is best will depend on the tear and shape of the earlobe being repaired. Also, it may depend on whether there is an intention to re-pierce the earlobe. Not all do. Another alternative to pierced ears is magnetic Earrings.
Most insurances will not cover this procedure as they consider it cosmetic in nature.

A really good article with nice, clear instructions on the Z-plasty technique is:
REPAIR OF THE SPLIT EARLOBE USING A HALF Z-PLASTY; Journal of Plastic & Reconstructive Surgery, Vol 101(3):855,856, March 1998; Gajiwala, Kalpesh M.S., M.Ch.
Dr. Michael Bermant, MD ‘s website has some very nice photos of before and after repair.

Related posts
Mending a Hole (June 26, 2007)

1 comment:

Unknown said...

Thank you for this information.I want to let your readers know of a new style of earring that avoids tearing and stretching but also does not hurt like a clip-on. They're called hook-on earrings. Please see for more information.