Q: Dr. Eppley, I just had a old tragus piercing split. Is this something that can be stitched back together or will the skin grow back? Or does it require plastic surgery? If the latter, will it look normal after plastic surgery? Thanks.
A: While piercings are common on both the earlobe and the tragus of the ear, there is one anatomic difference between them. The earlobe is completely comprised of soft tissue, skin and fat only, and this is what holds the piercing in place. The tragus, however, has a central core of cartilage with skin on top. It is the cartilage which holds piercing in place and it is usually much more secure and resistant to stretching unlike the earlobe. When a tragal piercing splits, presumably by it being pulled on, the underlying cartilage may have split as well.
Like the earlobe, a tragal split will heal on its own due to the excellent blood supply. Whether it will heal with a notch or cleft in it is impossible to say. I would allow it to heal on its own and see what it looks like later. Scar revision can always be performed of the contour of the tragus is not perfectly smooth.
Dr. Barry Eppley