Earlobe repair is a common request in cosmetic facial surgery. Earlobe tears result from a variety of traumatic situations. A resurgence in body piercing and multiple facial and ear piercings is occurring in college-aged individuals. This increase in piercing will bring more piercing-related complications to the cosmetic surgeon. The author has outlined 11 surgical pearls to provide improved cosmetic results in the repair of torn earlobes. Also described is immediate repiercing of the earlobe at the time of the surgical repair. Preventive practices to decrease earring and earlobe trauma are also reviewed.