Repair of gauged earlobes: Case series and review of two techniques according to size

Background: Earlobe stretching is a common body modification typically performed in individuals under 30 years old. Individuals may later desire restoration of a natural earlobe contour. There is a paucity of literature regarding technique and outcomes for repair of the gauged earlobe defect. Aims and Objectives: The primary aim of this study was to provide a strategy to assess stretched earlobe defects and choose between the repair techniques of de-epithelialization and closure or excision and rotation. The secondary aim of this study was to evaluate complication rates of the two techniques. Materials and Methods: Retrospective review of all patients who underwent repair of stretched (gauged) earlobes at a single institution from 2012 to 2019. Patient demographics, maximum earlobe size, motivation for seeking repair, surgical technique, and complication rate were recorded. Results: Fifty-three patients underwent stretched earlobe repair. The average age was 25.9 years old; 60.0% of the patients were male. Defects repaired with de-epithelialization and closure had been stretched to an average of 12.4 (SD = 3.2) mm compared to 29.3 (SD = 10.9) mm for excision and rotation. The minor complication rate was 12.5% with de-epithelialization and 10.8% for excision and rotation. Motivations for seeking repair included a desire to look more professional for work (34.0%), personal preference (30.0%), and joining the military (23.0%). Conclusion: Smaller earlobe defects (15 mm) with nonptotic lobules can be repaired with de-epithelialization and primary closure, whereas larger earlobes (>15.0 mm) with ptotic lobules require excision and rotation. Stretched earlobe repair is a well-tolerated procedure, although a significant number of patients will require minor revisions.