Torn earlobes typically occur in one of two settings: 1) as the result of a sudden pulling of an earring with enough force that it tears through the skin and soft tissue or 2) after years of wearing heavy earrings that elongate the piercing hole and eventually pull through the bottom of the lobe. In the setting of a sudden tear, the skin edges of the torn sides typically do not reattach but instead form a layer of skin on opposite sides of the tear. The result of both scenarios is a straight-line tear of the lobe that needs to be reattached with a minor surgical procedure.
Fixing a torn earlobe is a very simple procedure performed under local anesthesia in a sterile field setting. Some authors describe fairly complicated designs for the repair wherein flaps of skin are moved about to prevent a notching of the lower border of the earlobe. In actuality, the simple repair wherein freshly made edges are sutured together in a line is most commonly performed.
Prior to the procedure, the edges of the opposing sides of the tear are marked. The lobe is then numbed and made sterile. The skin edges that are on opposite sides of the tear are trimmed with either a scalpel or scissors so that two “fresh” edges of skin are created. The edges are sutured together with several stitches that are left in for 5-7 days. If the edges are not trimmed and made “fresh”, suturing will not work as the skin surfaces that oppose each other will prevent the sides of the tear from attaching together.
There is very little pain during the recovery. At most, over the counter pain medications may be necessary but certainly not narcotics. The earlobe may be slightly swollen for 24-48 hours. Stitches are removed 5-7 days later. It is strongly advised that the earlobe is not repierced for another 6-8 weeks so as to prevent separation of the repair. When the earlobe is repierced the hole is designed to be outside line of the repair. Over time, as the scar matures, the lower border of the earlobe at the very end of the suture line may retract and appear “notched”. The possibility of this occurring must be communicated to the patient prior to the procedure so that is it is not a surprise.