A Method of Cleft Earlobe Repair with an Intact Inferior Margin

Abstract

Introduction: Body art has become an increasingly popular and mainstream trend. Often, patients who chose to modify their bodies at an early age discover later that their ideas and perceptions have changed. Piercing of the earlobe is a common practive that can develop into a partial or complete tear of the earlobe. A challenge presented to cosmetic surgeons is to repair or revise a body modification and to restore a cosmetically acceptable physical appearance. Case Report: We present the case of a 23-year-old patient who pierced his earlobe. Over the course of several years, he increasingly stretched the pierced hole. The resultant dilated incomplete cleft produced a redundant drooped and lax free-hanging lobe. He presented seeking cosmetic repair of the altered lobe. The incomplete cleft was converted to a complete cleft by excision of redundant tissue near the medial attachment of the free-hanging lobe. A small ellipse was used to excise the expanded cleft and scar to de-epithelialize the margins. A Burrow's triangle was excised from the lateral base of the defect to facilitate a rotational flap created with the inferior border of the free-hanging lobe. With the method, the balance between the 2 sides was restored, and an intact inferior rim was produced with the incision line discretely concealed at the medial margin of the free-hanging lobe. Results: Postoperative follow up revealed a well-healed reconstructed earlobe closely approximating the natural lobe of the opposite ear. In addition to the symmetry produced, there is the advantage of an intact, uninterrupted inferior rim. Conclusions: Cosmetic surgeons are presented with increasingly complicated revisions of body alterations that are not fully addressed in the present surgical literature. With this case, we describe a unique approach that resulted in a positive cosmetic outcome with the advantage of avoiding any notching along the inferior rim of the earlobe. The rotational flap used in this case adds to the repertoire of repairs indicated when approaching repair of a similar earlobe defect.