This Article Has Been Medically Approved By

Dr. George H. Sanders

Compared to the entire face, the earlobe is but a small portion, but a most important one! An earlobe out of position after a facelift can ruin the result, and an earlobe with a poorly positioned or enlarged piercing hole can mar the look of an elegant pair of earrings. Let’s look at some types of earlobe problems and how they can be handled.

Incorrect Orientation – The angle that the earlobe makes with the ear should be angled 15º posterior to the long axis of the ear. See how the earlobe axis line is angled posteriorly relative to the ear axis line in this example?

(Dr. George Yang at

During the course of a facelift the plastic surgeon needs to cut out a place for the earlobe as he/she lifts the neck skin upwards. It’s critical to make this cut so as to position the earlobe with a posterior angulation as shown in the photograph.

• During the facelift, it’s also important not to place excessive tension on the earlobe  by cutting away too much neck skin, lest one end up with a “Pixie Ear” deformity. The earlobe is stretched downward, giving a very unnatural appearance.


Poorly Positioned or Enlarged Piercing Hole – When an earlobe is pierced it’s important to place the hole in the center of the earlobe. It’s also important that the holes be placed symmetrically in the two earlobes. If one wears heavy earrings, uses a phone while wearing earrings, or sleeps while wearing earrings, the pull on the earring may cause the piercing hole to stretch or even pull through. Fortunately there is a satisfactory solution to these problems. The hole is simply excised as a “pie-shaped” wedge of earlobe, and the edges sewn together. The scar that results usually fades nicely with time, and the earlobes can be repierced in a more correct location after 6 weeks. Please see the diagram below.


                           (Dr. Leslie Coker at

• I am often asked about earlobe reduction since earlobes may stretch in length with advancing age. This can be easily remedied with the same technique used for earlobe repair. In some cases the earlobe skin can be taken out at the junction of the earlobe with the cheek, giving a scar that is hidden in the natural crease. See diagram below.

                    (Dr. Ioannis Georgiou at

Feel free to comment!

George Sanders, M.D.