Can My Reconstructed Earlobes Be Further Improved By Scar Revision?

Q: Dr. Eppley, I had my earlobes reconstructed after several years of having them expanded by gauges. I was not completely happy with how they looked so the doctor has done a few revisions on them of which I am still not completely happy. Could you take a look at these pictures and tell me what you think. The left earlobe is a little red due to some recent laser resurfacing and I am ok with that side. It is the right side that does not look good to me. Is there any type of scar revision that would be further beneficial?

A: Thank you for sending your pictures. The left earlobe is in good shape and has a reasonably good connection to the face given there there is a deficiency of earlobe tissue. It does not appear to me that it would be improved by any form of further scar revision. (although I can’t really see the scar given its recent laser resurfacing but the connection to the face looks natural) The right earlobe shows some scar widening but it has less of a good connection to the face with some obvious tethering and pull down. This is undoubtably a reflection that it may have had even less earlobe tissue to start with than that on the left side. Can this be improved by scar revision? The fundamentral problem is that there is not enough earlobe tissue. So to get the tissue closed during  the prior procedure some facial tissue was ‘recruited’.  This is why the connection is more unnatural as facial skin has been pulled into the earlobe area and this is a completely different type of skin than that of the earlobe. Simply cutting out the scar and reclosing it will not improve the underlying problem. However, a z-plasty through the scar or even a v-y advancement type scar revision at the lower edge of the earlobe should be able to improve the look of the earlobe-face connection.

Dr. Barry Eppley

Indianapolis, Indiana