To enhance their appearance, women and men have been wearing ear jewelries since ancient times. Various parts of the ear are pierced to better hold items such as rings, posts, and other objects in place. Unfortunately significant weight or trauma can pull through the ear tissue. A tear in the lobe or margin leaves a notch in the otherwise smooth continuous edge that is usually very visible and hard to cover with hair or clothing.
The soft ear lobe has skin and fat while other parts of the ear have cartilage for added structural strength. Contour irregularities of the cartilage are visibly noticed because the tissue over the cartilage is thin. Reconstructing the delicate shape of the underlying cartilage makes the reconstruction more complex.
Unpierced ears are less likely to tear. Heavy jewelries held by tiny wires can tear through the tissue when yanked or slowly over time with enough pressure. To prevent earlobe tear, take earrings out whenever young children are present as they have the tendency to grab the jewelry and pull.
Large or heavy earrings will also gradually stretch the hole and eventually tear through the lobe. Be careful with quick and jerking movements as this can damage the ear more easily during activity. Lighter and smaller adornments are safer.
There are different forms of reconstruction depending on the deformity. In all methods, the skin lining the slot is removed creating a raw edge to rebuild. Lost tissue complicates matters and reconstruction is focused around reestablishing normal proportions in a somewhat smaller ear.
The raw edges are brought directly together using a combination of dissolvable sutures in the deeper layers and skin sutures that are removed at a later date. The ear could be pierced at the same time or at a later date. A straight closure like this has increased risk of scar contraction causing a notch at the bottom of the lobe after healing.
Tissue cut in a special pattern and moved with its blood supply is called a flap. Flaps are used to redistribute tissue and sculpt the shape of the ear. Flaps lessen the chance of scar notching. The ear could be pierced at a later date.
A series of flaps are designed and moved to rebuild both the skin hole for the jewelry and close the ear in one stage.
Injection of local anesthetic numbs the earlobe. Anesthesia wears off after several hours. After surgery most patients do not need pain medication. If any pain medication is needed, plain Tylenol or Advil seems to work well.
You will need to wash the wound with soap and water three (3) times a day. A thin layer of antibiotic ointment is the only dressing in most cases. You may wash your hair but will have to be careful with blow dryers until sensation returns. (You could burn yourself without knowing it if you were still numb.) Expect a little drainage from the wound. The sutures are removed in 7 days.
Usually, the ear is pierced immediately, but not in the wound itself. A small stud earring is placed and left in place for at least 6 weeks before changing. Heavier jewelry is not recommended, but if you must, wait at least two months after surgery. All the above time periods may need to be delayed if you still have sensitivity at the surgical site.
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