Natalie Amrose-Rosenthal didn’t wear pierced earrings for almost 10 years. After donning heavy earrings for decades, the holes in her ears stretched so low that her earlobes were almost ripped in two.

“It was pretty disgusting,” said Amrose-Rosenthal, a freelance designer in New York. “When I’d see myself I’d think, I don’t know if other people want to look at me.”

But when big earrings started coming back into fashion, Amrose-Rosenthal decided she wanted to get the problem fixed. She had earlobe repair surgery—a minor plastic surgery procedure completed under local anesthesia. A doctor repaired the ripped earring holes and about six weeks later re-pierced them. Today, she wears both small studs and bigger chandelier earrings and says she feels confident about her ears.

In today’s nip-and-tuck culture, ears that sag and wrinkle or stick out too far are becoming more common complaints as well.

Dermatologists and plastic surgeons are doing a robust business on procedures that focus on the ear. They include surgeries to repair elongated holes, contour stretched lobes and pin back protruding ears.

More than 26,000 people had cosmetic ear surgery in 2004, a 15 percent increase from 1997, according to the American Society of Cosmetic Plastic Surgeons. While that number was down 5 percent from the previous year, the percentage of people over 18 having cosmetic ear surgery has increased dramatically. In 2002, 35 percent of clients were over 18, and in 2004, that rate jumped to 54 percent.

David Rosenberg, a plastic surgeon in New York, says younger ears are generally able to withstand the weight of heavy earrings or the trauma of a sharp tug on an earring.

“But inevitably, over the years, the weight—or an accidental trauma—will lengthen the earlobe piercing or tear it through,” he said.

But some doctors say earlobe stretching has nothing to do with the earrings themselves.

As people get older, their earlobes naturally get longer. The trait is also influenced by genes, according to Dr. Patrick Sullivan, a professor at Brown University’s School of Medicine who studies ears. Protruding ears can be inherited as well.

Though Americans today prize the petite, contoured ear and tiny piercings, other cultures have seen the appendage differently.

The Buddha often appears with earlobes that hang down to his shoulders, said Michael Coan, chair of the jewelry design department at the Fashion Institute of Technology in New York. Others point out that paintings and sculptures suggest African, Asian and even early American cultures also shared this aesthetic.

“Ancient Asian cultures considered big and long ears to be consistent with moments of good life and long health,” said Dr. Michael Bermant, a plastic surgeon from Chester, Va., whose Web site features cartoon caricatures of the actor Clark Gable with Dumbo-like ears.

And now some Americans aim for elongated lobs as well. The neo-tribal aesthetic of elongated earlobes filled with ear spools or earplugs became popular in the 1990s as a symbol of cultural rebellion, according to Victoria Pitts, a sociologist at Queens College in New York who studies body modification.

“It’s not so rare in metropolitan cities to see stretched earlobes,” Pitts said.
Ears have long been a sensitive subject. During the Middle Ages and Renaissance period, European women covered their ears, considering them an intimate part of the body, Coan said. Petite earlobes and earring decorations came into fashion in the 17th century. “Little pink earlobes were very hot, and a pearl that trembled was very hot,” he said.

While many people today have always felt self-conscious about their ears, some believe the ear aesthetic is perpetuated by plastic surgeons and women’s magazines.

“Culture’s relentless in its impact,” said Deborah A. Sullivan, a sociology professor at Arizona State University and author of “Cosmetic Surgery: The Cutting Edge of Commercial Medicine in America.”

“I’m always amazed by what leads people to decisions to have cosmetic surgery done—just a passing statement by somebody,” Sullivan said. “Then they get it in their minds that, ‘Oh, my earlobes make me look old.’”

Stephen Bosniak, a New York cosmetic surgeon, said many women choose to have the surgery after seeing a pamphlet in his waiting room.

“A lot of people have that complaint and have that problem,” he said. “A lot of people don’t know that it can be fixed.”

Rosenberg says any time a client comes in for a face-lift, he will look at the earlobes as part of the initial assessment. Nearly half of the patients who have face-lifts also have earlobe repair surgery. Rosenberg does about one earlobe repair surgery a week, he said.

Andrea Spiritos, a psychoanalyst in New York had her ripped lobes repaired last year after Rosenberg suggested her piercings were too low. A few months later, her 16-year-old daughter decided that she too needed the surgery before her ears ripped.

“I didn’t go to her and say, ‘Your ear’s looking weird.’ She knew,” Spiritos said. “I said, ‘You don’t have to deal with it. We can fix it.’”

Bermant said that patients with torn or sagging earlobes or ears that stick out usually cover the appendage with hair or clip-on earrings.

“Talk to any patient who has ears sticking out. They have been tortured, cruelly treated by the public,” Bermant said.

But some people opt out of the surgery because of the expense involved—usually upwards of $500 to $1,000 per ear to repair or contour a lobe, and thousands more to pin back—a process of manipulating the ear tissue—or re-shape ears.

Cynthia Rome, a New Orleans pediatrician who has torn earlobes, said she was not ready to have the surgery. She prefers using special earring backs called Pierce-Mates that she buys online. The discs pull the earlobe pieces together in order to hold an earring in place.

“I used to wear big bright earrings to keep the kids’ attention,” Rome said of her patients. “It worked, but I had several kids who would tug on my earrings.”
Roberta Huntington, a mother of five from Westerly, R.I. who had surgery to contour stretched earlobes last winter, said she wore pierced earrings for 20 years to cover her lobes.

“I wouldn’t even go to the beach without them—my ears were so big,” she said.
Huntington worries that her daughters will have the same problem.

“They wear these huge earrings. I think they’re all going to end up with huge lobes,” she said.