Earlobes can split gradually by wearing heavy earrings or accidentally when an earring is torn from the earlobe. Split earlobes can be surgically repaired with specially designed skin incision and precise suturing. The site of previous piercing can be closed, or a tiny hole for continued wearing of the earrings can be preserved. Earlobe reconstruction is done as an outpatient procedure under local anesthetic. Sutures are removed after 7-10 days.

As a part of the aging process earlobes can become elongated and stretched-out. A permanent crease may form around old piercing holes that assume more oblong and vertical shape. Drooping and malpositioned earlobes are corrected in combination with a facelift or as an individual procedure with short incision hidden in the natural crease behind the ear. The correction of the earlobes is done under local anesthetic as an outpatient procedure. There is almost no downtime and sutures are removed after 7-10 days.

A pixie ear deformity is the condition where the earlobe is attached to the cheek without a crease between the earlobe and facial skin. Earlobe is poorly defined, stretched and elongated. Pixie ears can be an inherited condition or, more frequently, they can result from improper positioning of the earlobe during facelift surgery. Correction is accomplished by an outpatient procedure under local anesthetic. Reconstructive technique depends on the nature and severity of the condition. Basically, the attached earlobe is released from the cheek to hang freely and then the cheek skin is secured to the deep tissues behind the ear to hold the cheek in place without any tension on the earlobe.

Some people have a tendency to form bad scars. Keloid is a type of scar that grows beyond the boundaries of the original wound. They present as firm fibrous nodules and frequently occur at the site of ear piercing. They can also develop after ear reshaping surgery. Careful surgical technique can minimize the risk of keloid scarring after surgery, but can by no means completely prevent its occurrence. Treating keloids is a challenge since, as unfortunately it cannot be guaranteed that they will not return. In many instances, the best treatment option is to remove it surgically and start with immediate injections of steroids. Injections of steroid should be repeated monthly as needed. Surgery alone has a very high rate of recurrence. Additional application of compression earrings can also be helpful to prevent regrowth of the keloid.