Earlobe repair is not easy

My son has those large holes in his ears that are so popular now. He wants to "close them up." Is a surgical procedure required? What needs to be done?


Yorba Linda

Simple slits in the earlobe -- those that occur from wearing loop earrings for many years, or when an earring has caught on something and ripped the lobe -- can be easily repaired by making an incision at the site and stitching the area closed, says Dr. James Bradley, chief of pediatric plastic surgery and associate professor of plastic surgery at UCLA.

But reconstructing an earlobe that has been deliberately expanded to accommodate a large disc isn't nearly as simple.

These holes typically start small, and then are expanded over weeks and months by inserting larger and larger disks into the space. The hole can be stretched up to several inches in diameter.

"What they're doing is tissue expansion," says Bradley. "Once the skin is stretched in this way, it generally won't resume its normal shape, or normal form, and it can be very difficult to reconstruct." The more it is stretched, the harder it is to reconstruct, because there's less of the lobe to work with.

If the hole is relatively small, about one-fourth inch, the surgeon can move some of the tissue on the lobe to create a complete but smaller lobe. But if the hole is larger, the surgeon will have to use skin from behind the ear to reconstruct the front of the lobe, in a two-stage operation. In some cases, a cartilage graft may be needed as well, and then there will generally be some visible scarring on the front and back of the lobe.

Insurance may cover some of costs of the surgery, depending on the carrier, but typically this is considered an elective, patient-paid procedure.

A simple repair will cost about $800 to $2,000; a more complicated repair will range from about $1,500 to $4,500.