Changes in the earlobes are common over time, yet they are often overlooked until they begin to affect how earrings sit or how the ears appear overall. Patients may notice stretching, thinning, or elongation and wonder what can be done to improve it.
While surgical repair is one option, not all cases require it. In this blog, Dr. Lisa Ishii reviews what contributes to stretched or sagging earlobes and when nonsurgical treatments may be appropriate.
Why Do Earlobes Become Stretched or Sagging?
Earlobes, just like all other skin and soft tissues in our body, are susceptible to aging and sun damage. As we get older, we lose both collagen content and volume in the ears. This can be exacerbated with use of heavy earrings that may distort the piercing opening over time and further stretch the skin. Furthermore, earlobes are oftentimes neglected in skincare and photoprotection. Sun damage hastens this aging process.
Common Concerns Patients Notice
Many patients notice that their earlobes aren’t as supple as they used to be — this can present as thinning of the lobes themselves or downward tilting of stud-type earrings. Others may notice that the skin of the ears look more crepe-y and earring openings remain elongated even after removal of heavy earrings. Others may notice more obvious sun damage over the ears in the form of actinic keratoses (pre-skin cancers) or other photodamage-associated lesions and changes.
Less commonly, some patients may notice a diagonal earlobe crease, called “Frank’s sign,” which can be a potential sign of underlying cardiovascular disease and peripheral vascular disease.
In fact, from 1997 to 2013, cosmetic auricular surgery has increased by 81%, showcasing patients’ concern about ear appearance.
Do All Stretched Earlobes Require Surgery?
No. If the volume loss is mild to moderate and earring opening is still functional, non-surgical approaches can be utilized to restore youthful contour and function.
Nonsurgical Treatment Options for Earlobes
For volume loss and for Frank’s sign, hyaluronic acid gel-based fillers (HA fillers) can be utilized to restore volume and contour. This can help better support stud-type earrings and is a high satisfaction procedure for many patients. If elongation of earring opening is mild, this intervention can also help restore better opening configuration. HA fillers may require a series for optimal results. Common types of HA fillers we use at Aesthetic Solutions include Evolysse fillers, Juvederm fillers, Restylane fillers and RHA filler.
If there is substantial sun damage such as brown spots and crepe-y skin, a pigment-targeting laser combined with a CO2 laser can help restore youthful skin quality.
If obvious Frank’s sign (a diagonal crease or wrinkle in the earlobe that extends at a 45-degree angle from the tragus to the outer edge of the auricle) is present, I always recommend visiting your primary care provider if you do not see one regularly to screen for cardiovascular disease.
When Surgery May Be More Appropriate
If earring opening is substantially elongated, or even has torn or split, surgical intervention is needed first to restore appearance. Earring openings created from gauges almost always need surgical intervention.
How Long Do Results Last?
HA fillers typically last at least 12-15 months in this area. For laser treatment for skin quality and coloration targeting, this lasts longer with appropriate maintenance with photoprotection.
The Bottom Line
Stretched or sagging earlobes are a common concern that can develop gradually over time. While some cases require surgical repair, many can be improved with nonsurgical approaches that restore volume and support.
If you are in the Raleigh, Durham or Chapel Hill area and seeking treatment, contact our office for more information.
