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With age, so many body parts lose their youthful tautness and become stretched out, limp, and, well, loose. Known as volume loss (caused by a decrease in collagen and elastin), when the plump tissue of the [ears](https://aedit.com/concern/ear-shape) starts to dwindle, in its place surfaces wrinkled, aged, and flaccid earlobes. “Just like how we lose volume in the face, which causes it to become sunken and aged, the same thing happens to the ears,” says [Jason D. Bloom, MD](https://www.bloomfacialplastics.com/), a double board certified facial plastic and reconstructive surgeon in Bryn Mawr, PA. 

If you are familiar with the treatment options employed to address facial volume loss, then you are already familiar with the minimally invasive procedure that can restore your lobes. The same dermal filler that rejuvenates the face can be injected to revive [sagging earlobes](https://aedit.com/procedure/earlobe-restoration-solutions), and we’re breaking down everything you need to know.

## **What Causes Earlobe Volume Loss**
Before we discuss earlobe filler as a treatment, it’s important to understand why your lobes deflate in the first place. [Collagen](https://aedit.com/aedition/guide-to-collagen-in-skincare-supplements-aesthetic-medicine), the naturally occurring protein that supports plump, firm skin, starts to degrade at a rate of about one percent per year after 30. A loss of collagen equates to aged earlobes. Dr. Bloom compares aging ears to the transformative journey of a grape. “When you think of a fresh, young grape, it is ripe with fullness, but, as it loses volume, it shrinks down to a raisin,” he says. “The same thing happens to the ears. Over time, they lose fullness and begin to look long and droopy.” Whether you realize it or not, “it’s a lack of volume that can make the ears appear longer than they are,” Dr. Bloom adds.

But it’s not just time, age, genetics, and gravity that take their toll on the ears and cause skin laxity. [Kathleen S. Viscusi, MD](https://www.dessna.com/), a board certified dermatologist in Marietta, GA, says heavy earrings that pull on the skin over time can cause stretched-out earlobes, too. “The earlobes are especially vulnerable,” she shares. “Heavy earrings can draw down the skin and elongate the hole more so than it does naturally over time.” If you’re not ready to part with your ear party, at least pay attention to how you wear them. “When wearing heavy earrings, be sure that the backings support the weight of the earring,” she notes.

## **The Quick Fix for Sagging Earlobes**
A few injections of [hyaluronic acid (HA)-based filler](https://aedit.com/aedition/everything-you-need-to-know-about-dermal-fillers) can drastically transform sinking earlobes into perky ones. Dr. Bloom says that adding HA filler directly around pierced holes plumps them and the lobe, which prompts earrings to sit up better. “The key is to inject a bit of Restylane® or Juvéderm® right where the hole is — not too high above it or below,” he explains. 

But HA fillers aren’t the only injectable that can restore volume. [Jennifer Segal, MD](https://www.metropolitaninstitute.com/our-doctors/), a board certified dermatologist in Houston, TX, reveals that she sometimes uses Sculptra® (a biostimulatory poly-L-lactic acid filler) right above and below a pierced hole. “Both injectable products add support to the earlobe and give a tightening effect to the hole,” she says. Often times, the urgency of the procedure is how she determines which filler to use. “If a patient needs a quick fix, like for an event, I’ll use hyaluronic acid,” she explains. “Otherwise, I like to inject Sculptra®.” For creases in the earlobe, Dr. Segal notes that hyaluronic acid fillers do a better job at smoothing out lines and wrinkles. 

In the case of HA, the effects of the virtually painless procedure are immediate and last anywhere from nine to 12 months. “In the ears, there is no movement, unlike the lips and facial folds, so the lobes can retain and hold filler there for a pretty long time,” Dr. Bloom explains. Post-treatment care will have you donning bare ears for a few days. “That’s because the ears can swell, and earrings can compress it,” Dr. Segal says.

But it’s not always just the earlobe that needs tending to. Dr. Segal says that the fat pad that sits right in front of the ear can also have an aging effect. “As we get older, we lose definition in the jaw, and the shape of the face transforms,” she says. “The sharp contours are lost, the face appears rounder, and the area in front of the ear becomes more wrinkled as changes occur to the underlying structure.” The fix? “By adding back some of the lost volume, the triangle area right in front of the ear — where the jaw and ear meet — looks less hollow and more youthful,” Dr. Segal explains. “Bypassing this area can sometimes cause the ears to look overly large and sort of like Dumbo.”

## **Beyond the Needle**
Fillers work wonders for most age-related ear concerns, but there are some instances where surgery is necessary. For example, if the circumference of the earlobe changes, only a surgical procedure can permanently correct it. While fillers plump the area, [earlobe surgery](https://aedit.com/procedure/earlobe-surgery) excises loose skin and corrects severely marred piercings by either cutting out or trimming the holes, stitching them up, and then re-piercing the ears. While surgery may be required for some, “hyaluronic acid fillers are what I use 90 percent of the time to correct aging ears,” Dr. Bloom notes.

If a quick round of injections isn’t your thing, a quick treatment of [microneedling with radiofrequency (RF)](https://aedit.com/procedure/microneedling-with-radiofrequency) is another option. “It helps with volume loss, too,” says Dr. Segal, who performs [secret™ RF](https://cutera.com/secretRF) in her practice. The combination of RF and microneedling works nicely because the energy portion of the treatment encourages tissue tightening, which complements the collagen induction therapy.

And then there are those who are concerned about brown spots and sun damage. “The ears are exposed to dangerous UV rays, which can cause aging and also skin cancer,” Dr. Viscusi warns. Since it’s far easier to prevent damage than it is to correct it, she recommends applying your facial [sunscreen](https://aedit.com/aedition/best-sunscreens-of-2021) to the “often overlooked” ears on a daily basis. “I tell patients to think of applying sunscreen to the ears like brushing their teeth — you wouldn’t leave the house in the morning without doing this important step,” she says. Similarly, your lightening and brightening skincare products can be applied to the ears as well. “So often, skincare routines stop at the face and neck, but it should extend to our earlobes,” Dr. Viscusi adds.

## **The Takeaway**
If earrings are your favorite accessory to sport but heavy hoops and mega danglers are painful to wear, filler can help revive stretched-out earlobes. The result of this quick fix is younger and plumper-looking earlobes that allow your favorite studs to sit perfectly upright.

Aesthetics

A quick fix that allows you to flaunt your best ear bling.

Dermal Filler For Stretched-Out Earlobes And Piercings

This 10-Minute Treatment Corrects Stretched-Out Earlobes

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If you think back to your high school biology class, you likely learned that the nose and ears never stop growing. For some, that’s a daunting thought (even if the veracity is up for debate). Ear shape is a common concern that doesn’t discriminate by gender or age, which is why [otoplasty](https://aedit.com/procedure/otoplasty) is among the few aesthetic procedures performed on patients younger than 18. “An ear deformity is often noted at birth or during the first year of life as the ear grows,” explains [Melissa Doft, MD](https://doftplasticsurgery.com/), a double board certified plastic surgeon in New York City. “An ear will be 85 percent of its adult size by age five.” 

We’ve talked a lot about the [rise in eye-related cosmetic procedures](https://aedit.com/aedition/popularity-of-eyelid-surgery-cosmetic-eye-procedures-during-covid-19) in the wake of the [COVID-19 pandemic](https://aedit.com/aedition/plastic-surgery-dermatology-cosmetic-dentistry-practices-reopening-during-covid-19), but plastic surgeons have noticed a marked increase in inquiries about otoplasty (i.e. ear surgery). Between Zoom meetings shining a spotlight on the head and [face coverings](https://aedit.com/aedition/how-to-treat-prevent-acne-caused-by-covid-19-masks-face-coverings) putting a renewed emphasis on the eyes *and* ears, those who were already self-conscious about their ears might notice their protrusion more and those who never really took a second look might suddenly be scrutinizing. So, here’s what you need to know about ear pinning procedures.

## **What Is Otoplasty?**
“Otoplasty refers to ear pinning surgery that addresses a prominent, or lop, ear,” explains [Gary Linkov, MD](https://aedit.com/provider/gary-linkov-md-6976), a board certified facial plastic and reconstructive surgeon in NYC. The procedure can be performed a number of ways to address specific ear shapes and concerns, but it involves manipulating ear cartilage. “During a prominent ear correction surgery, cartilage may be cut, removed, or left in place and modified with suture to accomplish the main objective,” he shares. “The skin may also be removed to avoid bunching as the ear pin back surgery is performed.”

## **The Ideal Otoplasty Candidate**
“An ideal patient is one who has prominent, abnormally shaped, or oversized ears,” Dr. Doft says. Health and age do play a factor when undergoing any surgical procedure, but children as young as five can be candidates for otoplasty.

Bullying is often the reason why parents will opt for surgery for their younger children. “Given that the ear is almost adult size and five year olds are often too young to bully each other, this is the time most parents will elect to have their child undergo surgery,” Dr. Doft notes. In teens and adults, Dr. Linkov cites self-confidence is a big factor. “Prominent ears can be a common reason for ridicule in both children and adults,” he explains. “Having the ears corrected often restores confidence and gives people the option to wear different hairstyles.”

For adults, the procedure can be done in-office under local anesthesia or in the OR under sedation (depending on patient and provider preference), but “all children have the procedure performed in the operating room,” Dr. Doft says.

## **Types of Otoplasty** 
As we mentioned, there is no one way to perform otoplasty. “A prominent ear usually has three abnormalities: an enlarged concha or a bowl of the ear, loss of the antihelical fold, and an obtuse angle between the ear and the scalp,” Dr. Doft says.  “All three aspects of the ear are corrected during an otoplasty.” The best technique to achieve a pinned back look depends on the anatomy of the ear. They include:

- **Incisionless Otoplasty**: This minimally invasive option requires no deep incisions “but cartilage may need to be scored and sutures [may need]  to be used,” Dr. Linkov says.  
- **Conchal Setback**: This technique requires “the back of the ear to be exposed through an incision and the concha to be ‘set back’ against the mastoid bone using suture,” Dr. Linkov explains, adding that “sometimes a piece of the conchal cartilage is removed or weakened to further assist the setback.”
- **Mustarde Sutures**: Surgeons can “recreate an antihelix with a series of strategically placed ear sutures done from the backside of the ear,” he says. The sutures are permanent. 
- **Cartilage Sculpting**: Used only for specific indications, Dr. Linkov explains that it creates the desired shape through cartilage sculpting or reshaping.

[Combining techniques](https://aedit.com/aedition/best-surgical-and-non-surgical-cosmetic-procedures-to-combine) is common practice depending on the situation at hand. Dr. Linkov often performs a hybrid of conchal setback and mustarde sutures because “most patients have both an underdeveloped antihelix and an oversized conchal bowl.” By combining the methods, he can address “the vast majority of prominent ears in an elegant and long-lasting way.” 

## **Recovering from Otoplasty**
Otoplasty results are virtually immediate, and because the procedure is considered minimally invasive, the [recovery process](https://aedit.com/aedition/how-long-does-it-takes-to-recover-from-cosmetic-surgery-procedures) is short and manageable. As with any surgical procedure, bruising and swelling are common for up to two weeks post-op. There is potential for risks such as “bleeding, infection, hematoma (blood collection), over-correction, and return of the deformity,” Dr. Doft notes. 

Immediately after surgery, a secure bandage will be placed around the ears. Within the first few days, patients can return to have the dressing removed, and Dr. Linkov recommends a light compression garment be worn during the day for an additional two to three weeks. He tells patients to “avoid scratching or manipulating the ears for two weeks following surgery and to stay away from strenuous activities and contact sports for three weeks.” 

## **The Takeaway**
Otoplasty is a great solution for those who are self-conscious about their ear shape or size and are looking for long-lasting results. “Otoplasty is one of my favorite operations, as a change in self-confidence is evident from the very first postoperative visit,” Dr. Doft shares. “From raising their hand in the classroom more frequently [and] wearing their hair in ponytails to feeling confident on a sports team [and] cutting their hair short, it is truly a life-changing procedure.”

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Large or protruding ears are a common concern for people of all ages, and the solution is a simple otoplasty or 'ear pinning' procedure that achieves quick results with little downtime.

Benefits Of Otoplasty And Ear Pinning Procedures For Large, Prominent Ears

Why This Lesser-Known Cosmetic Procedure Is Currently Trending

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Getting piercings can be a rite of passage. Some people have had ear piercings for as long as they can remember, while others can remember the excitement of finally being able to get their ears pierced as a teenager. These piercing holes might look great now, but that doesn't mean they're exempt from changes. Over the years, either from wearing heavy earrings or by voluntarily stretching them, the skin around the area can become loose. 

Many patients consult dermatologists or cosmetic surgeons because they dislike the appearance of their older piercings or feel the loose skin is a giveaway of their age. And though it is easy to fix, earlobe sagging and other undesired piercing scarring is often overlooked as part of a more traditional anti-aging routine. Piercings on other parts of the body can also be affected by a range of factors, including the general aging process and pregnancy. One particularly common complaint is the appearance of navel piercings after having children, but, like earlobe repair, it's an easy fix.

## **What Causes Earlobe Sagging?**
There are two primary causes for ear piercings becoming larger over time: wearing heavy earrings for long periods and purposefully stretching earlobes using spacers. As with any part of the body, with age, skin becomes weaker and shows a loss of elasticity due to lower levels of collagen production. The earlobes themselves also tend to get larger throughout adulthood, a phenomenon that is mostly attributed to gravity. 

## **How Can Earlobe Sagging Be Treated?**
Earlobe sagging can be treated through [corrective surgery](https://aedit.com/procedure/earlobe-surgery) and can be carried out as a procedure on its own or as part of more widespread treatment. “The procedure is straightforward and is carried out using local anesthesia," says board certified plastic surgeon [Michael Frederick, MD](https://aedit.com/provider/michael-frederick-md-643), of Hass Plastic Surgery in West Palm Beach, FL. "When there is a large amount of excess skin, it can be a little more complicated, but with a bit of ‘skin origami,’ patients will be able to achieve the results they were looking for.” Most commonly, the procedure involves sewing the opening closed and removing excess skin to refashion the shape of the earlobe. Dr. Frederick says he commonly addresses stretched earlobes in conjunction with other operations. It's particularly common in combination with [facelifts](https://aedit.com/procedure/midfacelift), but the procedure can be done if you are [under anesthetic](https://aedit.com/aedition/8-cosmetic-procedures-you-havent-heard-of) for almost any other cosmetic procedure too. Pricing for earlobe piercing correction as a stand-alone procedure varies widely, between $300 and $1,000 depending on what type of repair is required and whether or not you want the procedure on both ears. 

## **Are There Any Possible Complications?**
Dr. Frederick notes that it’s important to be mindful about re-piercing the ear after the repair is carried out. "The ear can be re-pierced within days of the procedure if it is pierced in a different place to the scar," he says. "However, if the patient wants a new piercing in the exact same place, they will need to wait up to six months for the scar to be strong enough.” Since scar tissue is more delicate than normal skin, re-piercing too soon could result in the need for further corrective surgery by damaging the scar. 

The risk of infection in the area is no higher than any other procedure, so keeping the area clean and appropriately bandaged after the procedure should prevent possible infection. 

There is little downtime for this procedure alone. If it is carried out using only local anesthesia, patients will be able to return to their daily activities within hours. Stitches remain in place for about a week, and after they are removed, caring for your scar is important by applying a topical scar treatment.

## **What About Other Piercings?**
Piercings in other parts of the body can also leave marks, either from the scar left behind once they are taken out or from stretching during pregnancy or weight gain. Both surface piercings (piercings that have an entry and exit point such as nose piercings and navel piercings) and dermal piercings (piercings held in place by a base) can be corrected by a dermatologist or cosmetic surgeon. The main goal of repairing a piercing is to restore the area to its natural appearance before it was pierced and the principle for treatment is similar to that of ear piercings. The practitioner will create a small incision and create a new, neat scar designed to disappear once healed. 

## **What About Stretch Marks Around a Navel Piercing?**
Many women who had their navel pierced before they had children find that the area around the piercing tends to accumulate a large number of stretch marks during pregnancy. The treatment for these stretch marks is different than for those who are simply looking to remove the pierced skin, mainly because stretch marks are more widespread. Your practitioner may suggest having the piercing addressed in addition to treating the stretch marks. Stretch marks can be treated using a number of methods including laser treatment and microdermabrasion. The cost of treatment varies depending on the location of the marks and you can expect to pay a further $500 to $900 for stretch marks treatment depending on the size of the area being treated.

## **Are There Any Possible Complications?**
Similar to ear piercing repair, the risks associated with body piercing corrections are minimal. Most of them are carried out under local anesthesia and require little downtime. With careful wound management, they should not be particularly prone to infection. Patients should contact a board certified dermatologist or cosmetic surgeon if they are considering having the procedure. If you will be undergoing treatment for stretch marks around a navel piercing, you can expect a level of discomfort after either [laser](https://aedit.com/procedure/ablative-nonfractional-lasers) or [microdermabrasion](https://aedit.com/procedure/crystal-microdermabrasion). Patients often say it feels like a sunburn, but this should only last a couple of days following each treatment. 

The ability to virtually erase any trace of an old piercing is attractive to many patients and the ease of the procedure makes it a viable option for most people. Patients do need to keep in mind that there will be a small scar after the procedure, but if they take good care of it during the healing process it can disappear over time. It is a good idea to discuss how to reduce scarring when you have a consultation with your physician, particularly if the piercing that is being treated is in a very visible spot as it could take longer to fully heal. 

Perfect piercings don't last forever.  Luckily, it's easy to fix sagging, stretched or old piercings. Plastic surgeon Michael Frederick, MD, tells us just how easy.

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Ear and Body Piercings