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Dr Tim Neavin
Surgery with Symmetry
Dr Tim Neavin

Earlobe Repair Surgery in Beverly Hills

On the face, two areas continue to grow with age. Can you guess what two areas? One is the earlobe. Two is the nose.

What is the role of the earlobe, anyway? Anthropologists have suggested that the earlobe in the human developed as an erogenous zone, given their lack of any known biological function and their robust nerve supply.

There is no doubt that the earlobes have turned into a focal point for fashion, evident by the sparkling pieces of jewelry that dangle for all to see. Thus, men and women do care about their appearance, even if we don’t know why we have them.

There are many units of a face that when viewed together as a whole, produce an image of youth or age. Thus, a real facial rejuvenation should include as many components as necessary to reverse the hands of time. The “done” look is often a result of patchwork surgery: a fresh face with a sagging neck, or full cheeks and droopy eyebrows, for example. Even the elongated ear lobes that you think nobody else may notice may still impart an aged look to your face. The good news is that earlobe surgery is rather easy, and the results are immediate.

Before and After Photos

Earlobe surgery offered by Dr. Neavin also includes keloid treatment. Keloids are an exaggerated scar response often seen in darker pigmented people. They are common in the earlobe. The management of keloids can range from steroid injections, to surgery and excision of the keloid, to surgery and a short course of radiation therapy. Sometimes health insurance will cover keloid surgery. The recovery is often quick, and it can be done in the office under local anesthesia in certain cases.

Earlobe repair is often necessary when the earlobe is torn from either trauma or an earring that stretched the piercing or ripped through the earlobe tissues (mechanical division). The goal of earlobe surgery is to either rejuvenate the earlobe (and face) with an earlobe reduction, or repair any tissue to restore the ability to hold an earring properly.

Earlobe Reduction

Earlobe reduction surgery can be performed in a number of ways, depending on the desired look and scar position. To reduce the earlobe, tissue must be excised. The incision may be placed along the rim of the earlobe or slightly behind it, in the middle of the earlobe where it meets the face.

All three approaches can reshape and reduce the earlobe, but have their limitations as to what they can achieve. The scar from the procedure will thus either be in the middle of the earlobe, along the rim or the lobe or slightly behind it, or in the natural crease where the ear meets the face.

The most versatile approach is the mid-earlobe incision. However, it may leave the most visible scar. While scars on the earlobe generally heal very well, in some individuals with dark skin, the scar can thicken or create a keloid. When the scar on an earlobe heals without a keloid and is closed properly by the surgeon, it is generally not very noticeable after a few months.

Mid-Earlobe Incision

The mid-earlobe incision is the most versatile incision to reduce and reshape the earlobe. A wedge of skin is removed in the shape of a triangle and closed. The reduction of the earlobe is proportionate to the amount of tissue excised. The incision is closed in a mattress fashion along the rim to approximate with exactness the margins of the earlobe to prevent a step-off or notch. This is a critical component of an attractive closure.

Often, the mid-earlobe incision is used simply to approximate torn edges or reduce the piercing size if it has stretched. The tissues on the edges of the wedge are corrected with a superficial incision and then closed in front and behind the earlobe.

The procedure can be performed under local anesthetic in the office and the recovery is rather quick. Mild swelling can last a couple of days and stitches may be removed in the office by the seventh day.

One should not re-pierce the ear for three weeks after surgery.

Rim Incision

A common technique to reduce the earlobe involves the resection of the lobe along the margin. This is a precise approach to shape the ear with great ease and predictability. Tissue is resected in a crescent shape along the inferior border of the earlobe and closed on the under-surface of the new lobe margin or just behind it.

The advantage to this incision is its ability to shape the earlobe with great ease. There are really no limitations to the amount of reduction one can achieve. The disadvantage is the potential for poor scarring if one is prone to hypertrophic scarring or keloid formation. The propensity for a thick scar is greater with this approach than the mid-earlobe incision mainly because there is inherently greater tension applied to the closure with this particular type of skin resection.

In cases where one may be prone to poor scarring, such as individuals with darker skin or a history of keloids or large scars, either ear clips can be used post-operatively to reduce keloiding potential, or the mid-earlobe approach may be more suitable.

This procedure can also be performed under local anesthesia. Swelling may persist for a few days. Stitches placed will either be of the dissolvable type or need to be removed in seven or eight days.

Base of Earlobe Incision

A third approach to reduce the earlobe and reshape its attachment to the base involves a resection of tissue with or without a rim component.

Some earlobes are attached (connected to the side of the face), and others are unattached (termed “free”). Whether the attached or the free earlobe is more attractive is open to debate. However, many men and women request an attached earlobe, with or without concomitant earlobe reduction.

An incision can be made at the free edge of the earlobe and tissue can either be excised vertically or along the margin to reduce the size and create an attached earlobe. Generally, small to moderate earlobe reductions can be performed with only a vertical excision at the earlobe base. Larger reductions will require the addition of a marginal incision.

It should be noted that during facelifts, this incision is incorporated into the facelift incision since the incision necessarily wraps around the earlobe.

The recovery for this approach is similar between the three techniques. Mild swelling will persist for a few days. Either dissolvable stitches will be placed or stitches will need to be removed in the office seven or eight days after your procedure.

Whether you are unhappy with the appearance of your earlobes or you have seen damage and changes over time, Dr. Neavin has customizable solutions for you. To learn more about your options in earlobe repair, contact Artisan of Beauty Plastic Surgery at 310-858-8811 or text 323-975-1287.

FAQ

What are some of the common earlobe procedures?

The most common earlobe deformities are split earlobes, enlarged piercing holes, and elongated earlobes. The first two are related to trauma. Big earlobes often result from prolonged use of heavy earrings or even the natural aging process.

What is a split earlobe deformity?

A split earlobe is a separation of the skin on the lobe causing a split-like appearance.

What causes a split earlobe?

Split earlobes are almost always caused by piercings and trauma related to piercings. Other causes may include bites or other trauma.

What is an earlobe reduction?

An earlobe reduction is a procedure that restores a smaller, more youthful looking earlobe. The procedure is done in the office and is often combined with other facial rejuvenation procedures such as a facelift or facial fat grafting.

Why do my earlobes continue to grow?

You are normal if you have noticed that your earlobes are larger now than they were, let’s say, 20 years ago. Earlobes and the nose are two components of the face that continue to enlarge over time. Even men and women who have no history of wearing earings will see growth in their earlobes.

What type of anesthesia is used for earlobe surgery?

Earlobe repairs can be performed in the office under local anesthesia. However, they are commonly performed with other facial rejuvenation procedures such as a facelift and fat grafting that often require the person to be asleep.

Walk me through an earlobe reduction or split lobe repair

You will arrive to the office. It is fine to have food or fluids before the procedure. Topical numbing medicine will be applied to your earlobes and around the lower part of your ear. Local anesthesia will then be injected into the lobe and around portions of the ear. The ear will be wiped with either alcohol or betadine, and you may be re-positioned on your side or lying down. Sterile drapes are placed around the ear and you are tested to see if the earlobe is numb. Once totally anesthetized, the incisions are made and closed with stitches. Bacitracin and a bandage will be applied.

How long does the procedure last?

Each earlobe can take about 30 minutes to complete.

How much time off work or school is required?

No time off work or school is required after the most common earlobe procedures. However, you will have some mild swelling and stitches may be visible for up to seven days after surgery.

Will I have permanent or dissolvable stitches?

It depends. Most procedures where the incisions are made behind the ear receive dissolvable stitches. Permanent stitches that will need to be removed are placed in areas of more visibility.

Do stitches need to come out?

Some may need to come out and others may stay in and dissolve. If the dissolvable ones don’t dissolve within two weeks, they can be removed in the office.

When can the earlobe be re-pierced after earlobe repair?

Sometimes the earlobe can be re-pierced the same day as the procedure. In other cases, it is wise to let the swelling subside, which may take up to three weeks.

What are the risks and complications of earlobe repair?

Every procedure carries some type of risk. However, earlobe repair is a very safe operation. The most common complications include issues related to healing such as poor scarring, the formation of a notch where the skin meets, and infection. Revisions can always be made. It should be noted that smokers tend to heal poorly and every effort should be made to avoid nicotine products for at least four weeks before the procedure to optimize the scar.

Will I have a scar?

Virtually every external incision will form some type of scar. A scar is the body’s natural healing response. Everyone has their own genetic predisposition to scarring. Some will heal so well that the scar is virtually invisible to the human eye, while others may keloid. The best marker for scarring is prior scars you may have as this offers an indication of how your body heals. The second is a good surgical closure with appropriate suture selection and timely removal of stitches. Sunscreen, massaging, and scar creams also help to reduce visible scarring.
The scars for earlobe reduction are camouflaged well in the natural contours of the ear. For split earlobe repairs, it may follow natural contours of it may run through the earlobe, depending on the specific repair needed.

When can I exercise after surgery?

It is wise to avoid strenuous exercise for 48 hours after earlobe surgery to minimize the chance of bleeding and to reduce pain.

Can I drive home after surgery?

Generally, one can drive after surgery unless anxiolytics like valium or narcotics were taken.

When can I shower or wash my hair?

One can shower the next day as long as common sense is exercised. Don’t scrub the area. The most gentle shampoo is Johnson and Johnson baby shampoo.

Are there any prescription pills I’ll need to take?

Generally, narcotics will not be needed, but a prescription can be provided if necessary. Antibiotics may be taken for a few days following surgery to prevent infection.

When do I follow up after surgery?

Follow up is generally five to seven days after surgery. Dr. Neavin will also see you a few weeks later to ensure proper healing.

Are there any medications I should avoid before surgery?

Earlobe surgery is a surface operation. There is no risk to any major vessels or nerves. However, bleeding into the surgical site can make the operation less precise than desired or delay wound healing. Dr. Neavin may advise you to stop some medications or take other steps to lower bleeding risk before your surgery.
Earlobe repair is usually a straightforward procedure with minimal discomfort and downtime involved. To learn more about your choices in this procedure, contact Artisan of Beauty Plastic Surgery at 310‑858‑8811.

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