The 15-year-old girl just wanted her upper ear pierced, like all her friends. Her mom didn’t think twice; in fact, she even considered following suit. But a week later, her daughter’s ear began to swell and she was put on antibiotics. The next day, the swelling was worse and the ear about twice its size. At the emergency room, the fluid was drained from the ear and it deflated like a balloon. All the cartilage had been eaten away by the very virulent bacteria that required IV antibiotics for six weeks to clear up. Plastic surgery restored only partial normalcy.
Dr. Gregory Branham, chief of Facial Plastic and Reconstructive Surgery at Washington University School of Medicine, has seen such cases all too often. He says even the common practices of upper ear piercings and nose piercings have a great risk because they go through cartilage, which is not self-regenerating. “A cartilage infection can dissolve the cartilage and result in significant deformity,” he explains. “On the outer edge of the ear, losing cartilage removes the visual outline that makes the ear look normal. Compounding that are all the super bugs like methicillin-resistant staph infections (MRSA) and other bugs that have proliferated in recent years. This wasn’t as much of an issue in decades past, but if you get one of those organisms, they are very difficult to treat.”
Another area Branham frequently sees pierced is the eyebrow. While it has no cartilage, brow piercing leaves dimples and a bald spot in the brow that is very hard to cover. Branham says parents need to have a conversation with a minor child about why they want the piercing. At a certain age, young people may just want to do it because of peer pressure and needing to belong, but they also should know the possible ramifications.
Dr. Samer Cabbabe with Cabbabe Plastic Surgery says piercings have a variety of hazards. “There is a risk of big scars, called keloids, particularly in African Americans,” he says. “Like tattoos, piercings can result in infections and diseases such as hepatitis if good technique isn’t used. And some people find they are allergic to the metals in the jewelry.”
Even if the initial piercing is uneventful, over time, problems can arise from the jewelry worn there, Cabbabe warns. He has fixed split earlobes from long use of heavy earrings or having an earring ripped out. Even if the ear lobe doesn’t tear, the hole may become enlarged and elongated with heavy earring use and still require surgery to fix. He says as the younger generation ages, he is seeing more problems with piercings, including scars and holes. “If you must have something pierced, have it done at a place that is licensed and clean, and check to make sure the needles are sterilized. Ask to see them taken out of the package,” he advises.
Dr. Bruce Kraemer, chief of the Division of Plastic Surgery at Saint Louis University, says before you pierce, consider the location. He says anything visible on the face can make the difference in a tight job market between getting and not getting a job, and self-esteem isn’t helped by facial scars from piercings gone wrong: Lip piercings can leave tears in the lip with visible scars. Ripped out nose rings are also a tricky fix because cartilage is involved. Tongue piercings, because of the germs in the mouth, can lead to infection and scarring, as can metal allergies in any area.
Kraemer adds that people thinking about genital piercings should consider this: Infection can cause permanent damage to sexual organs, and major tissue loss, among other things.
Kraemer says before getting a piercing, other than the ubiquitous earlobes, people should ask themselves if there is a chronic unhappiness that needs to be addressed and for which piercing is seen as a solution. Can parents and kids work out their relationship, so kids feel valued and not ignored by their parents? “Consider all these things beforehand. Go into piercings with logic, not during a drunken stupor,” he says. “It’s wonderful to be young and rebellious, but if you are looking at a piercing as a life-changing event, is there some other more life-affirming way that will stand the test of time?”