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Earlobe Reconstruction

shutterstock 132023537 300x300 - Earlobe ReconstructionEarlobe Reconstruction – Dr. Burton Sundin & Dr. Reps Sundin, Virginia

Ear reconstruction, or Otoplasty, can involve the entire ear or only part of the ear, such as the lobe. Earlobe reconstruction is a much less involved procedure than other ear reshaping surgeries.

Earlobe tears can make the ear look unattractive. Men and women both wear ear jewelry to enhance their appearance. Unfortunately sometimes significant weight or trauma can pull ear jewelry through tissue. A tear in the lobe or margin leaves a gap in the otherwise smooth connected edge. This tends to usually be very visible and hard to cover with hair or clothing.



What is actually torn?

The soft ear lobe contains skin and fat. Other areas of the ear have cartilage that add structural strength to the ear. Irregularities of the cartilage are easily seen, since the tissue over the cartilage is usually very thin. Through reestablishing the delicate shape of the ears underlying cartilage, complexity is added to the reconstruction.

How do I prevent this from happening?

The obvious answer is to not pierce your ears, as this way they are less likely to tear. When ear jewelry is pulled at sharply it can tear through the tissue or over time enough pressure could cause this to occur. When you are around young children take the earrings out. Young children tend to grab jewelry and pull hard. Bigger jewelry or large hoop earring are more easily grabbed by their little hands. Studs are less likely targets for young children but there is still the possibility they will cause damage.

Large and/or heavy items can gradually elongate the piercing and eventually possibly tear right through the earlobe. Larger items have greater momentum and damage more easily occurs during activity. Lighter smaller jewelry is always safer.

What are my options for reconstruction?

A majority of ear holes gradually enlarge over time. The final tear normally occurs through a tiny piece of tissue near the bottom of the lobe. If only the bottom of the lobe is actually torn, immediate repair won’t take care of the skin covered slot. However if the tear begins from a small pierced hole, you do have the option for immediate repair. Otherwise reconstruction must be delayed until after the wound has healed and tissues are no longer inflamed.

Reconstruction can take different forms depending on the type of tear. In all methods, the skin lining the slot is removed creating a raw edge to rebuild. Lost tissue complicates the reconstruction which must then center around reestablishing normal proportions in a slightly smaller ear.

  • Technique 1 (“Jelly Roll” flap): A series of flaps are designed and positioned to rebuild not only the skin hole for the jewelry, but also close the ear in one stag
  • Technique 2 (layered closure): The raw edges are connected directly together using a combination of dissolvable sutures in the deeper layer of the lobe and skin sutures that are removed at a later date. No specification for the jewelry hole is made at the time of the procedure. Several months of healing later, the ear can be pierced again if you so desire. A straight closure like this has the increased possibility of scarring and can cause a notch at the bottom of the lobe after healing.
  • Technique 3 (“Z-plasty” flap): The tissue cut in a special pattern and moved entirely with its blood supply is called a flap. Flaps can be used to redistribute tissue and sculpt the shape of the ear. Flaps have a decreased chance of scar notching. If you choose to, the ear could be pierced at a later date.

Anesthesia

A local anesthetic is used to numb the earlobe. The anesthesia will wear off after several hours. Post-surgery most patients do not need pain medication. If you do require any pain medication, plain Tylenol or Advil seems to work well. 

Postoperative Care

Clean your wound with soap and water three times a day. In most cases, a thin layer of antibiotic ointment is the only dressing needed. You may wash your hair but you must be careful with blow dryers until sensation returns to the earlobe (otherwise there is a chance you could burn yourself without knowing it if your ear was still numb.) You should expect a little drainage from the wound and be careful of your good bed linens with the drainage and ointment. Sutures are removed in about seven days 

When can I wear earrings after surgery?

If Dr. Sundin has rebuilt the ear including a hole for jewelry, you will have a temporary “ring” at the end of surgery which comes out in about two weeks. The new hole will be quite weak for a short period of time and you should hold off trying small posts for at least six weeks after surgery. Heavier jewelry is never recommended, but if you must, give your ears at least two months after surgery to heal completely. Clip on earrings may be worn as soon as six weeks after surgery. All the above time periods could need to be delayed if you still have some sensitivity at the surgical site. 

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If your ear has been closed completely and you want to repierce the ear, you must wait at least six months after surgery and the scar should be soft before you try this. 

Scar Care

The wound will start out firm. Dr. Sundin has most of his patients massage their scar with cocoa butter 15 minutes a day beginning two weeks after sutures have been removed. Over time the massaging seems to soften the scar.

Be aware that NOT all surgeons offer the same types of earlobe reconstruction. There is a lot to learn about this procedure. This website is only an introduction to what the Virginia Institute of Plastic Surgery has to offer. We take the education of our patients extremely seriously.

Please use this introduction to become comfortable with Dr. Sundin, his caring service, ear reconstruction abilities, and what we have to offer.

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NORTHERN VIRGINIA
(Washington DC Area)

Vienna
1500 Cornerside Boulevard
Suite 400
Vienna, Virginia 22182
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