The wearing of gauges for a significant period of time can result in severe deformities of the earlobes which can be more difficult to repair compared to standard earlobe clefts caused by heavy earrings or allergic reactions to certain metals found in jewelry.
Remove the Gauges
In response to the size and weight of the gauges, the skin of the earlobes not only stretches, but also actually grows so that there is redundant skin after the gauges are removed. Before performing corrective surgery, it is important for the gauges to be left out of the ears for several weeks to allow the skin to retract and recover from the trauma that they cause. This allows for better determination as to how much skin needs to be removed and how much lifting will be necessary.
Just like correcting split earlobes from standard earrings, the skin that has grown along the margins of the cleft has to be removed. In addition, the extra skin on the bottom of the earlobe must be completely taken out in order to create a relatively naturally looking earlobe that is not too large, too long or too wide.
The design of the skin removal takes some planning, experience and artistic ability in order to predict the eventual outcome. The fact that the skin of the earlobes has been stretched and traumatized for an extended period of time makes the procedure more difficult to plan and execute. During surgery, some form of cautery will likely be necessary to reduce bleeding before the sutures are placed and some absorbable internal stitches may be needed to strengthen the closure. This is not typically necessary with standard cleft earlobe correction. It is possible that some revision surgery may be necessary to obtain the best outcome from cosmetic ear procedures.
In general, there will be a scar from the skin removal and repair which is usually a straight line running from the top of the earlobe to either the bottom or somewhat to the side depending on direction that the earlobe opening runs caused by the trauma from having the gauges in place. Additional horizontal or oblique scars may also be created during surgery depending on what needs to be done to create the most natural ear shape.
Thick, unsightly scars such as hypertrophic or keloid scars can form on earlobes, especially in the African American population. Fortunately, if these scars have not developed from the wearing of earrings or gauges, it would be unusual for them to form as a result of corrective earlobe surgery.
Patients may re-pierce their ears after several months have passed from the corrective surgery. It is best to wait until the earlobes are completely healed and the hole should not be placed right on the scar from the repair, which will never be as strong as the adjacent skin that is unscarred. The scars should be mature and the earlobes should feel soft and natural before re-piercing.