Split earlobes usually occur as the result of wearing heavy earrings. With time the piercing track elongates and eventually ‘cheese-wires’ through the lower margin. Occasionally, an earring catches and tears, leaving raw edges. A recent fashion trend has seen people progressively stretch earlobes so there are 3 main reasons for surgery.
- The elongated piercing that has not yet fully split so can still support an earring, but studs tend to dislodge
- Full split – also known as a bifid lobule, the track has broken through the free margin
- Tribal earlobe – this is the progressively stretched lobule that often requires repair for potential employers, particularly the British armed forces. This is quite different to the first two as permanent damage has been caused to the lower border. Repair is more complicated, takes longer and has more scarring although the final appearance is invariably a great improvement.
More questions about Split Earlobe Reconstruction?
You should both fit for any surgery and likely to heal without undue problems. It is also important to establish that you have a clear understanding of what can, and cannot, be achieved. You must not smoke, either before or after, to optimise healing. You should also advise the surgeon of regular medications in case any need to be stopped before the operation, including aspirin.
Similar to the dentist, LA (local anaesthetic) is used and will sting momentarily whilst being injected. Only when the area has become numb will surgical repair begin.
Partial and full splits may undergo direct repair in which the skin edges are carefully excised and the incision repaired, often with absorbable stitches. This is quick and easy, but the area must be left to heal for a good 3 – 6 months, ideally with a different site, if repeat piercing is desired.
An alternative is a flap of skin that is rolled onto itself to preserve the piercing hole. This is only possible when there is sufficient tissue and it takes more time to perform. A large stitch is usually left in the piercing tract to keep it open until earrings can be worn again.
Tribal ears are the most complex. Because the lobe has been permanently stretched, the tissue is distorted and ‘notching’ of the border is more common. Final scars are usually longer, but are usually highly acceptable.
After the operation either antibiotic ointment or a light dressing is applied to the wound.
Whilst you can return to normal daily activities immediately it would be wise to avoid strenuous exertion, such as the gym, for a week or two. There will be some discomfort as the LA wears off, but paracetamol is generally more than adequate and should be taken as soon as any pain appears.
It is advisable to sleep with extra pillows to elevate the head and reduce swelling. There may be a little blood-stained discharge so an old pillowcase is recommended for the first few days. If applying antibiotic ointment hands must be clean before its application.
Suture removal will depend on what type has been used: non-absorbable stitches require removal whereas absorbable ones disappear of their own accord. Whilst most people are happy to remove dressings and monitor their own incisions, a review appointment may be scheduled with the nurse 1 week after the operation. Arnica tablets for a week post-operatively seem to reduce swelling and bruising.
Naturally, your split is exchanged for a scar, which is permanent. In the great majority it becomes a thin, pale line that blends in. It is, however, important to appreciate that scars take 12 – 18 months to complete their maturation process and are at their most active during the early stages (2 – 6 months). You should limit sun exposure for the first year.
Overall healing and recovery time is around 2 weeks and you should plan to see your surgeon at 6 – 12 weeks to assess the scar. Massage is can aid scar maturation.
WHEN CAN EARS BE PIERCED AGAIN?
We recommend 6 months after surgery if the direct technique has been used. If a flap, you should be able to start with a small stud soon after your dressing clinic appointment. Remember that your lobes will be weaker that before the repair and returning to heavy earrings risks recurrence.
Any operative intervention carries the risk of potential complications. These are rare with modern techniques, but there is still an element of natural variability in wound healing.
Local anaesthesia has very few complications the main one being an allergy, which is exceedingly rare, but must be communicated to any future medical or dental practitioners.
Surgery will always be accompanied by some bleeding, but in minor procedures this should be no more than minor discolouration of the dressing. Active bleeding later usually reflects excessive activity, but firm pressure for 10 minutes will always control it.
Infection is uncommon, but possible any time the skin is breached. Usually no more than a nuisance, antibiotics may be required at times. If really unlucky, the wound may open delaying healing with more appointments required for changes of dressing.
On very rare occasions scarring is excessive. If red, hardened and raised for a longer period it is hypertrophic. The term keloid is applied where scar tissue grows beyond the boundaries of the original wound and remains for an extended time. Both are more common in coloured skin and something to consider when having surgery for cosmetic reasons. On the other hand, a scar might not knit together so strongly and stretch.
Recurrence refers to a return if the preoperative state and is almost always due to too early a re-piercing and/or too heavy an earring.
Overall, ear lobule repair is relatively risk-free and is associated with an high degree of patient satisfaction.