A long-term review of Z-plasty technique for repair of split earlobes

Abstract

Split earlobe injuries are relatively common in individuals with pierced ears. Complete lobe clefts occur from either sudden pull injuries or from chronic traction. A variety of techniques exist for the plastic surgeon to reconstruct this area. In surgical repair, maintenance of lobule contour and prevention of notching are of the highest importance. The objective of this study is to present the technique, results, and outcomes of our split earlobe patients. A 10-year retrospective review of one surgeon’s (I.T.J) split earlobe cases was performed. Repairs involved resection of the edges of the split area followed by a Z-plasty at the edge of the lobe. We perform a complete closure without preservation of the original piercing hole. Re-piercing is performed after at least a month. Forty-three patients were included, and eight had bilateral involvement. Average follow-up of the patients was around 4 months. A variety of etiologies were responsible for the split. One patient developed hematoma and infection which was resolved with antibiotics. Another patient developed notching and required revision surgery. The other 41 patients in our study were noted to have satisfactory form and function after surgery—meaning a well-rounded and well-contoured lobe without notching. No patient had recurrence of the notching. For complete split earlobe injuries, a full-thickness excision is advised and closure is achieved by a Z-plasty. Secondary re-piercing is performed. We have had no recurrences, the rate of revision is very low, and all who save one patient (97%) were satisfied with the result.