Large earlobes can be the result of one’s genetic inheritance or it can develop as one ages and the wearing of heavy ear rings in women. As a general rule, the length of the earlobe should be no more than one-fourth to one-fifth the height of the ear. But a large earlobe is obvious to the naked eye and does not require a ruler to determine if it is too big. Large ear lobes can not only be too long but can stick out also.
Reducing the size of an earlobe is a relatively simple plastic surgery procedure. It can be done in the office under local anesthesia in about 30 minutes per lobe or it can be done in the operating room when other larger procedures are being done. (e.g., facelift) Since no cartilage is present in the earlobe, a simple wedge removal of skin can make them look significantly smaller. There are several different options for where to take this skin wedge from and it all depends upon where one would like to place the final scar and whether the earlobe is completely attached to the side of the face or not.
The most common and preferred method of earlobe reduction is the medial (inner) approach or to take the wedge of lobe skin out from the side where it attaches to the face. This is the most natural location to put a scar in such a skin crease. There will be a tail of a scar that goes through the middle of the earlobe to join up to a crease in the lower part of the ear that contains cartilage. When the ear completely attaches to the side of the face, this is the best approach. When one has a large earlobe that does not attach directly to the face (space exists up to where the main body of the ear attaches), then a simple V-shaped wedge from the upper part of the inner earlobe works well. There are also lateral or outside earlobe reduction approaches, which also work very well, but they put a scar line that runs through the outer rim of the earlobe.This can result in a more noticeable scar or potentially a notch can form along the earlobe rim.
Earlobe reduction is a simple but powerful procedure for making it smaller. I also frequently do them at the time of a facelift as some patients have large earlobes and adjusting its size as one is already working around the ear is a convenient time to do so.
Dr. Barry Eppley