Are there other surgery options to help close piercing holes? (Photo)

Question

About 10 months ago I got surgery to close piercings on my right ear and most of them look the same, as if I never got the procedure done. Would something like a laser treatment help smooth out the holes' appearance or would it be safe/reasonable to try the regular procedure again? Any recommendations are appreciated.

Raffy Karamanoukian, MD, FACS · Answer

Earlobe repair is a common procedure in our plastic surgery office. I employ a technique that involves removing the excess scar tissue and reapproximating the tissue planes in multiple layers to recontour the earlobe after gauges, torn earlobes, or stretched out earlobes. Sometimes, the same procedure is used to restore contour to a pixie ear after facelift surgery or facial surgery. Gauge correction is a popular treatment. Insurance typically does not cover the procedure in California, but it all depends on your insurance policy. Costs are typically between six hundred dollars and one thousand dollars depending on the complexity of the repair. Pixie ear repair involves correction of the facelift flap and is a more complex procedure that requires anesthesia. Aftercare for earlobe repair involves proper wound care, Plato’s Scar Serum at least twice daily, with repiercing of the earlobe if requested, in 6 weeks. It is best to have a plastic surgeon perform the procedure and help with scars in the post-procedure period. Plato’s Scar Serum, wound care, and Neosporin are used.

Best,
Dr. Karamanoukian
Realself100 surgeon

Best, 
Dr. Karamanoukian
Realself100 surgeon

Elliot M. Heller, MD · Answer

Earlobe repair is a very common procedure. Frequently, we have patients who will have the procedure done the same day as the consultation. Typically, the cost is between $450-850 per earlobe, depending on the severity and the length of the procedure.You may be able to find a doctor who will do this under insurance but i am not aware of any.The length of time the ears have been gauged should have no effect on the procedure. As long as the tissue is no longer irritated or inflamed, there is no reason not to give it a try. Gauged ears are sometimes more difficult than some other earlobe repairs since the tissue is so over stretched, but we are still able to create a natural looking earlobe. You can get your ear re pierced about 6 weeks after and should be included in the pricing. Shop around in your area and see if you can find a plastic surgeon in your budget

Jessica Lattman, MD · Answer

I would suggest re-excision of the holes, with attention to the closure.  I think a better result can be achieved that what you have.

Shayne Webb, MD · Answer

The only way to fix this in my opinion is by direct excision and meticulous closure.  Lasers/peels etc will not correct indentions of this nature.  Best of luck.

Ralph Trey Aquadro, MD · Answer

Lasers are not going to help.  The entire hole (all the way through to the other side) needs to be excised and meticulously closed.  I would recommend you find a plastic surgeon who can show you pictures of repaired ear lobes.Best of luck,Trey Aquadro, M.D.Auburn, AL

Nelson Lee Novick, MD · Answer

Closing off the holes from any piercing is not particularly difficult. But, since the initial creation of the hole was essentially a deep cut in the skin, scarring at the piercing site is another matter entirely.While it cannot be determined from the photos, it is not unlikely that the through and through holes were successfully sealed by the previous procedure and that what is being seen here are the surface dimples that often remain after ear piercing holes are sealed off. I doubt whether lasers, such as the fraxel, would be of much value, since in general my experience with them overall has been disappointing. They appear to be far more manufacturer backed marketing hype than hard science. Punch excisions, with suturing, is a possibility, although I would prefer the following to this more aggressive approach.The small, pit like residual marks on the earlobe could be managed, however, in a similar fashion to how we treat acne pit scars. The CROSS technique, which utilizes maximal concentration TCA placed deep within the pits would be one potentially very effective way of ensuring that the pits are entirely sealed and also by promoting greater closure out the surface outlet of the pit (in this case, the piercing dimples at the surface). Subsequently, a series of fractional microneedle resurfacing treatments can be performed to help blend still further the treated sites with the surrounding skin.

Greg Chernoff, MD · Answer

the photograph you submitted appears to show the piercings either closed  or still open. There is a procedure which would remove them all. It involves a one hour surgery, with a linear scar from the top piercing to the bottom. The resultant scar would eventually blend. There is not a laser that could  improve the appearance.

Joseph Shvidler, MD · Answer

I would use small biopsy punches to minimize tissue loss and perform meticulous tract removal and close the wound with delicate suture. It is also important to control the shape of ear lobe not to distort it too much

Gregory J. Vipond, MD, FRCSC · Answer

Even though your holes may have been closed, it appears that the incision has healed so that there are still indentations in the ear lobe. There are different options to address this. One option is to release the scar tissue in the earlobe through a procedure called subcision. This is generally followed with the injection of either fat or an artificial filler such as Restylane into the soft tissue of the earlobe. Another treatment option is to redo the repair with a better surgical technique so they are less likely to heal with an indentation.Laser resurfacing may subtly improve the dimpled aspect of the earlobe, but it may not completely eliminate the depression of the piercing.

Scott Shadfar, MD · Answer

Hello MT214, Thank you for the question. I am sorry you are having difficult with this. Without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of any treatments it is difficult to be comprehensive.From the photo it appears these scars have indentations in the center.  This is hard to treat with a laser or resurfacing procedure. I would consider cutting out the piercings and repair them with meticulous wound closure. I would seek care from a facial plastic surgeon to examine these areas and give you options for improving their appearance. Hope this helps. Dr. Shadfar