The three problems, and how the repair differs
"Earlobe repair" covers several different situations and the operation changes with each.
A complete split. The piercing has elongated downward and finally torn through the lower edge, leaving two separate limbs of lobe. The repair freshens both edges, closes in layers, and reconstructs the lower border. The key technical point is avoiding a notch: a straight-line closure of a straight-edged split tends to contract and leave a small dip in the lower border, so surgeons use a small zig-zag, a Z-plasty, a stepped closure or a wedge at the edge so the scar does not cross the border as a single straight line.
An elongated but intact piercing. The hole has stretched into a slot but has not torn through. Here the surgeon can either excise the slot and close it, converting it into a small repair, or leave it and simply advise against heavy earrings. Closing it is usually worth doing if you want to re-pierce in a better position.
A deliberately stretched gauge. This is the one that needs the most planning. A lobe stretched over years has three problems: a large hole, excess skin around it, and a lobe that has become long, thin and droopy. A simple closure of the hole leaves a lobe the wrong shape and size. The operation excises the redundant tissue, reduces the lobe to a proportionate size, and reconstructs the edge, and how much can be taken depends on how much lobe is left. Very large gauges can leave too little tissue for a normal-looking lobe, and in extreme cases reconstruction is limited by what remains. Ask to be shown what shape is achievable before you consent.
A traumatic tear. A fresh tear, within hours, can sometimes be closed directly, and one that has healed with a split edge is repaired as above.
A thin or cleft lobe, or an attached lobe some patients want changed. These shade into earlobe reduction and earlobe reshaping, and the earlobe reduction page covers size.
Both sides, and asymmetry. Lobes are rarely symmetrical, and after a split on one side only, matching the repaired lobe to the other is part of the task. Some patients choose to have the intact side adjusted slightly for symmetry.
Ask the surgeon which of these you have, how they will close the lower border to avoid a notch, and what shape they expect to achieve.



