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Un-Stretching Gauged Earlobes: Surgical Repair

An article published electronically in JAMA Facial and Plastic Surgery discusses what happens when ears have been stretched beyond the body's ability to heal.

Every generation has its signature look—or actually, a number of signature looks—and since the mid-1990s, people in the under-30 group seem to have embraced tattoos and piercing. This trend has a name: the Modern Primitive Movement. A small subset of young people has embraced the use of gauge earrings. These devices expand a healed piercing and are purported to self-heal if the final stretched diameter is less than 10 mm, although each person’s potential to heal differs. Our modern generation did not invent this practice. Indigenous peoples all over the world have stretched their ears for cultural, religious, and traditional purposes for centuries. King Tutankhamen is known to have worn gauge earrings. As with tattoos and other piercings, some people become patients when they tire of their body art. An article published electronically in JAMA Facial and Plastic Surgery discusses what happens when ears have been stretched beyond the body’s ability to heal.

As could be expected, some gauge earrings cause earlobe defects and in the worst cases can distort the lobe’s contour. The lobes will not heal spontaneously, causing patients to seek a surgical solution. This article, written by a team of plastic surgeons from Southern California, proposes a stratified assessment approach to determine the earlobe deformity’s magnitude and reconstructive techniques.

The authors used their own cases, 20 patients who requested earlobe reconstruction with at least 1 year of follow-up, and classified the stretch wounds by size (small, medium, and large).

Small defects cause little distortion to the earlobe’s contour. The authors report that they use a primary closure similar to that used for a torn earlobe, with closure in three layers.

Medium defects cause radial earlobe distortion and thinning, and the surgeon needs to recruit neighboring soft tissue to successfully close the tear. In this case, the authors advise advancement flaps or wedge excisions.

Large defects cause inferior displacement of earlobe border and vertical axis abnormalities. This is a much more extensive repair, and the authors have used advancement flaps and excision of redundant tissue with exceptional aesthetic results at 6 months postoperatively.

This is only one of 2 articles available to discuss this problem, but it’s very likely that more are soon to follow. Fortunately, surgical earlobe repair is available for followers of the Modern Primitive Movement who desire a more professional appearance later in life.