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Ear and Earlobe Scars and Keloids

Botched Ear Surgery:

Our office is a national referral center for all different types of scars. As you can imagine, there are many patients who have come to our office with ear scars that have resulted from botched cosmetic plastic surgery. Many of the treating surgeons certainly had good intentions, but the combination of surgical technique, wound care, postoperative scar treatment, and genetic scar characteristics rendered the scars visible. Unfortunately, there are no 'cookie-cutter' options for scar treatment with surgical scars.  Every patient presents with a different combination of scars and there are no predictable algorithms that can address poor scar formation resulting from cosmetic surgery.  Our expert plastic surgeon, Dr. Karamanoukian, utilizes a combination of surgery, laser, RF-treatments, injection, microneedling, topical therapy, and scar modulation techniques to reduce visible scarring. 

Ear scars related to botched plastic surgery usually have hypertrophic and keloid features. Some patients have dynamic scars that have occured from abnormal tension lines after facelift or necklift surgery. A common problem is known as a pixie-ear deformity caused by excessive ear pulling from a facelift. Problematic scars include those that have advanced to include part of the facial skin or cartilage of the ear. 

Ear Piercing Scars: 

There are many different types of ear piercings that are mostly identified by the anatomic area that the piercings are placed into. Some of these piercings may be in the cartilage of the ear, whereas some are in the soft-tissue of the ear, and others only in the skin. Some of the types of earlobe piercings include gauges, plugs, forward helix piercings, helix or helical piercings, posterior helix piercings, tragus piercings, earlobe piercings, anti-tragus rings, conchal, and industrial helix piercings. 

Many of these types of piercings can become inflamed, hypertrophic, keloid-like, or can be pulled, stretched out, or torn. In some cases, the piercings spontaneously close on one end or develop small cysts or bumps within the tissue. Some piercings have no inherent problem with them but patients sometimes have different life circumstances that prompt them to be removed and repaired. 

Procedures to treat ear piercing scars depend on the anatomic location of the piercing, the amount of hypertrophy or inflammation, and the presence of cartilage within the scar itself. Options include intralesional injection therapy (IIT), surgery, lasers, topical therapy with Plato's Scar Serum, and repiercing. 

Our office specializes in many different types of scar repair procedures for ear piercings. Some lesser known problems with piercings that can be addressed include hypergranulation tissue, cellulitis, piercing pimples, atrophic scars, piercing discoloration of the skin, dermatitis, traumatic tears, and localized infection. Some of these piercing problems may progress to hypertrophic or keloid scarring so early intervention is suggested.

Otoplasty Scars:

An otoplasty is a cosmetic surgical procedure that is performed to pin the ears back in patients who have prominent ears that stick out too far. Most otoplasty incisions are made in the back of the ear, where the conchal cartilage meets the back of the cranium. The posterior ear crease is typically a suitable place to hide an incision, but there is still a chance that the ensuing scar can become visible. Otoplasty scars can become noticeable if there is hypertrophic scar formation or keloid scar formation. Both of the these conditions necessitate intervention with either surgery, laser, injection of steroids, or topical application of Plato's Scar Serum. An otoplasty scar can be isolated to the skin or involve the cartilage of the ear. It is always a good idea to seek a consultation for otoplasty scars early, as delayed treatment may impact the longterm results of the otoplasty surgery. 

In our Santa Monica plastic surgery practice, we treat all different types of scars, including ear cartilage and otoplasty scars. Treatments generally do not require surgery and the scars may be improved with conservative treatments such as laser, injections, and topical therapy. 

Torn Earlobes:

Earlobe piercings may rip out or stretch, causing a torn earlobe.  A torn earlobe can occur over time (wearing heavy earrings) or as a result of acute trauma. The Correction of torn (or split) earlobes can be performed in a clinic setting using meticulous surgical technique. Dr. Karamanoukian is an expert in the repair of torn earlobes and can perform the procedure with minimal incisions and downtime.  Most surgical cases for split earlobes are performed with local anesthesia and requires less than one hour to perform in a sterile surgical setting.  More severe earlobe tears occur as a result of gauges or ear plugs.  Our office begins each consultation for scar repair with an examination to determine whether surgery or other non-surgical measures are appropriate. During your consultation, Dr. Karamanoukian will evaluate your earlobe, determine your candidacy for surgery, assess your downtime, and develop a plan that is carefully tailored to your needs.  Earlobe repair can be performed in our accredited surgical suite under local anesthesia. Once the surgery is complete, you will be discharged home with instructions for local wound care. Absorbable sutures are commonly used on the skin and rarely require postoperative suture removal. In some cases, small caliber non-absorbable sutures are used and can be taken out in about one week. Recovery after earlobe repair is relatively straightforward, with minimum aftercare and few dressings. You are encouraged to shower after your surgery and to use local wound care to take care of your incision line. Most patients will not require antibiotics or pain medications. 

Our office is often asked about earlobe repair and insurance coverage. Most insurance companies defer the cost of earlobe repair as they have deemed the procedure to have cosmetic foundations. Insurance coverage varies from policy to policy and we encourage you to contact your insurance provider to determine your eligibility for coverage. 

FAQ Torn Earlobes: 

Q: Can the earlobe be repierced after an earlobe repair? A: The earlobes can be repierced after an earlobe repair. We would suggest that you wait several months before your repierce your ears and that you choose a site that is different than the incision line of the earlobe repair. 

Q: Can I drive home after my earlobe surgery? A: Earlobe repair is an outpatient surgical procedure and does not require general anesthesia or conscious sedation. When your surgery is complete, you will be discharged by the surgical team and you can drive home yourself provided that it is safe for you to do so. 


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