Techniques For the Revision of Large Gauged Earlobe Defect

Ear gauges are a common body modification observed worldwide for both aesthetic and cultural purposes. Currently, the literature on surgical techniques for reconstruction of gauged earlobe defects is limited, particularly for patients with very large defects. Here, the authors present the successful implementation of 3 earlobe reconstruction techniques for comparison, and review the current literature on the topic. In addition, the authors introduce a novel hybrid 2-flap technique. This is a descriptive report on the implementation of 3 techniques for gauged earlobe reconstruction at a single institution. The approaches in this study include a vertical incision and closure and 2 methods of our 2-flap approach with de-epithelization and flap rotation. There were no intraoperative or postoperative complications and all patients were discharged on the same day as the operation with excellent results. The presented cases demonstrate an effective hybrid flap technique in which the medial flap creates the bulk of the earlobe and ensures the natural continuity of the helix of the earlobe. It achieves excellent cosmetic outcomes for large gauged earlobe defects. Surgical approach selection should consider defect size and shape, earlobe tissue characteristics, and patient preferences. Providers should use their clinical judgment as well as engage patients in discussions to select the approach that will yield the most satisfactory result.