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Earlobe reconstruction is surgery to repair deformed or damaged earlobes. The earlobe is easily manipulated for decoration because it has no cartilage, but this trait increases the earlobe's susceptibility to damage that requires surgical correction. Earlobe surgery is sometimes needed to correct a congenital defect or an injury resulting from earlobe trauma, but earlobe repair is most often required to repair the damage inflicted for decorative purposes, such as piercing and stretching, and the wearing of heavy earrings. All surgery carries some risks, but this type of ear surgery — which is frequently performed in the surgeon's office under local anesthetic — is fairly simple and straightforward, is relatively low-risk, and usually has a successful outcome.
Congenital defects of the ear that might require earlobe reconstruction include macrotia, or abnormally large ears; cup-ear deformity, in which the ears are oddly shaped and protrude abnormally from the side of the head; and cleft earlobe. Common injuries include splitting and tearing caused by heavy earrings or earrings that are accidentally pulled. Patients may also request surgery to correct natural stretching of the earlobes caused by aging or the wearing of heavy earrings. Some patients undergo surgery to correct intentional stretching, or gauging, performed to accommodate insertion of large plug, o-ring, or trowel-shaped jewelry.
Plastic surgeons often perform earlobe reconstruction in conjunction with more complex surgeries to correct congenital defects of the ear. For example, corrective surgeries to reshape large upper ears might also require the surgeon to correct the shape or size of the earlobe. This is accomplished by strategic removal of sections of the earlobe to tailor a natural shape and careful wound closure to preserve the more natural contour. Similar surgery is used to remove keloid scarring from injuries or ear piercing.
To repair a split earlobe or torn earlobe, the surgeon cuts the inner edges to create new straight-edged wounds and sutures these "freshened" edges precisely to produce a naturally shaped rim. Earlobe reconstruction for lobes excessively stretched lobes is accomplished in a similar way. After allowing time for natural recovery of the earlobe to occur after any inserts are removed, the surgeon removes tissue as needed and then sutures the "fresh" edges into a more natural shape. For any of these surgeries, the surgeon may use a flap technique, such as z-plasty flap or jellyroll flap, to reduce scarring and notching and ensure a natural appearance.
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