Loss of upper pole of ear following an infection, reconstructed with a costal cartilage graft, fascial flap and skin graft

Damage to the ear can be from many sources. Burns, dogbites, mechanical trauma, infection and complications of previous surgery can deform the  ear leaving it short of skin and cartilage and twisted out of shape. Many of the techniques applicable
to congenital ear surgery can be applied to post traumatic cases. Scar tissue often means that the native skin is unsatisfactory and has to be augmented with flaps and grafts. Sometimes more than one stage is required.

In New Zealand most post traumatic problems are covered by ACC.


Torn Earlobes or split earlobes can occur after an ear-ring is accidentally torn through the ear skin.Torn earlobes can be repaired under local anaesthesia. The piercing can be reconstructed or removed and a new piercing performed later if desired.

Stretched earlobes are similar to torn earlobes except the weight of heavy earrings has gradually stretched a piercing and the associated lobe without tearing through. Stretched earlobes can be repaired under local anaesthesia.

Keloid Scarring is an unusual type of scar formation. In this condition the body fails to turn off the scar forming process and the scar grows beyond the site of origin. It can occur after trauma or after an operation. Keloid scars are typically red and itchy. Normal scars soften and fade over 6 to 12 months whereas keloid scars persist in their active state. Keloid scars are more common in those of Asian or African origin. Treatment may involve injection of steroids into the keloid. Occasionally surgical excision is appropriate but the keloid may reappear. Pressure therapy may be useful for keloids of the lobe. Very occasionally radiotherapy is appropriate for very troublesome keloids. Keloid Scarring may be caused by ear piercing. For the general population the risk of Keloid scarring from prominent ear correction is approximately 1 in 50 cases.

A keloid scar after prominent ear surgery


A keloid after ear piercing










Cauliflower Earis caused by a hematoma (blood clot) forming under the lining of the ear cartilage. This causes new cartilage to form in the clot and a permanent lump is left. It is common in rugby players when the ear is crushed in a scrum. If the clot is drained immediately after the injury occurs the deformity can be prevented. An established cauliflower ear can be treated by shaving down the excess cartilage. It can be very difficult to return a bad cauliflower ear to normal.

A Cauliflower ear