Torn earlobes are also called split or cleft” earlobes and  are caused by  a sudden pull on an earring, prolonged traction from heavy earrings, tight clip-on earrings and fiddling with earrings.

They can be complete clefts, where the lobule is divided into a medial and lateral limb. These are usually one sided and are the result of trauma to the ear.

They can be incomplete, where there is a elongated hole in the earlobe. These are caused by  prolonged use of heavy, pendulous earrings, and are typically bilateral.

Another classification describes clefts as type I-III

Type I: The boundaries of the cleft hole extend less than half the distance between the original piercing and the inferior margin of the earlobe.

Type II: The boundaries of the cleft hole extend more than half the distance between the original piercing and the inferior margin of the earlobe.

Type III: The cleft hole completely splits the earlobe. 

Surgical repair: Numerous techniques for repairing torn earlobes have been described in the literature. These methods range from the simple excision of the epithelial tract with primary closure to the use of a Z-plasty design at the inferior lobular margin. Small skin flaps are also used to re-establish the earring site.  Partial clefts should be converted to complete clefts prior to definitive repair. This ensures a successful aesthetic closure and optimises the surgical repair. 

After the operation: You can go back to work the following day, although you will have a sore ear for a few days. You should take pain relief tablets such as paracetamol or brufen. Non-absorbable sutures are removed 5–7 post surgery.  Antibiotic ointment over the sutured incision is used twice daily for one week. Steristrips are used after suture removal to provide the wound with further support.

A conservative waiting period of 3 months before repiercing is recommended. Do not repierce through the repair scar, a new hole adjacent to the cleft repair is likely to minimize the risk of cleft recurrence. Also to avoid recurrence, it is better to avoid heavy and pendulous earrings. 

Risks: The earlobe can get infected. Also the earlobe can re-split, especially if the ear is repierced. 

Alternatives: The ear lobe can be left alone.

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