I have recently had several young patients wearing enlarged plugs in their earlobes. This “gauging,” as it is called, is obtained by placing larger and larger gauge earrings, eventually ending with a plug the size of a wine cork or even as large as a Coke can. The history of serial enlargement traces back to ancient times.1 This deformity is different than a through and through earlobe laceration, which can be caused by a heavy earring tearing through the tissues. Instead, these gauge sizes begin at 18 gauges (1.0mm) and increase in 1- to 2-mm increments up to 2cm or more. A tapering tool, which gradually transitions the piercing from a smaller to larger gauge along the length, can be used. Reversing the size of the earrings has been recommended to gradually reduce the earring hole, but this does not completely reduce overly stretched tissues.
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