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Ear Lobule Repair

Having your ears pierced can give you a way to express your personal style with earring fashions. However, there is also the risk of developing split earlobes. This is actually a very common problem that occurs more often than most people realize.

It can result from different causes such as:

  1. Wearing large heavy earrings that pull the earlobe downward
  2. wearing earring posts that are made of metals that can irritate the skin such as nickel
  3. accidents where the earring is pulled and tears the skin, creating a split in the earlobe Initially the hole can extend downward to resemble a slit. If the earlobes are not addressed by a doctor at this point, the slit can continue to grow until earlobe actually splits at the bottom.

Procedure-

Repair of Split ear lobule is usually done under local anesthesia. It typically takes around one hour to complete in the office. The degree of the earlobe tear and condition of remaining tissue and also patient's choice helps to determine the type of repair needed. A small piece of cartilage harvested from the same ear can be placed in to repaired lobule below the expected site of hole, may reduce the future chance of re-splitting of ear lobe. In surgical repair, maintenance of lobule contour and prevention of notching are of the highest importance.

  1. Layered Repair- The raw edges are brought directly together using a combination of dissolvable sutures in the deeper layers and skin sutures, which are removed at a later date. After several weeks (6-8) 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.
  2. Repair with Z-Plasty- Repairs involved resection of the edges of the split area followed by a Z-plasty at the edge of the lobe. It results in well-rounded and well-contoured lobe without notching.
  3. Earlobe repair with preserving the orifice- In Pardue's Technique the cleft edges are excised, and the skin of the upper portion of the orifice at one of the sides is preserved. A flap is created with that portion, which is rotated like a snail towards the opposite side and then sutured with nylon, with internal stitches through the dermis of its lower end at the prior orifice raw corner, forming a new orifice. The edges are closed with simple sutures from the anterior lobe to the posterior.
    Split earlobe repair using a double flap technique which avoids a straight-line scar that is prone to contracture and allows for the earring hole to be recreated in the original position and so earrings can be worn again without re-piercing.

Recovery

Injection of local anesthetic numbs the earlobe. Anesthesia wears off after several hours. After surgery simple pain killers for 1-2 days work well. You will need to wash your wound with soap and water daily after 2 day from surgery. A thin layer of antibiotic ointment is the only dressing in most cases. Avoid turtlenecks or tight fitting clothing for one week following split ear lobe repair. Patients typically do not need to take time off work other than the time for the surgery. Sutures are removed in about seven (7) days. Avoid unprotected prolonged sun exposure for three months following split ear lobe repair to prevent pigmentation of incision lines.

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