Earrings can be a beautiful, bright addition to any outfit—but they can also be quite heavy. And if you regularly wear heavy earrings, over time they can potentially do some gnarly things to your earlobes. Case in point: Dr. Pimple Popper’s recent “earlobe repair” video.

Dr. Pimple Popper is Sandra Lee, M.D., a board-certified dermatologist based in Upland, California. Lee films her most exciting appointments (with the consent of her patients, of course), and she shares them with her 2.5 million Instagram followers and 2.4 million YouTube subscribers. Most of her videos show her popping pimples—hence her nickname—but she shared an “earlobe repair” video this weekend.

The patient in question wore heavy earrings for years, and her jewelry stretched out her piercings from small, dainty holes to slits about a few centimeters long. It wasn’t the look she was going for—so Lee repaired her earlobes and stitched the piercing back together.

To fix the piercings, Lee first used a scalpel to “refresh” the wound edges (aka open them up). Then, once she cut open the piercing, she stitched the two parts of the earlobe back together.

While it may seem like a surprising procedure, Gary Goldenberg, M.D., a board-certified dermatologist, tells SELF he does earlobe repairs pretty frequently. Some of the repairs he does stem from women stretching out their piercings with heavy earrings. Other patients, however, need repairs after an accident where a heavy earring gets caught on something and rips their earlobe. (That very accident happened to Beyoncé during a concert last year.) “There’s some where the earring goes all the way through and totally separates the earlobe at the bottom,” he says. When big earrings are in style, Goldenberg says he sees more patients needing earlobe repairs.

Goldenberg says the way Lee fixed her patient’s earlobe is pretty standard. During the procedure, you have to remove a layer of skin—as Lee did with a scalpel—so strong scar tissue can grow and hold the two parts of the ear together after its stitched. Bleeding is necessary for the tissue to grow together. After the procedure, it takes about a year for the scar tissue to get up to 90 percent strength. At his practice, he tells patients to wait at least three months before they wear earrings again, and they should start with the lightest pair possible. “But sometimes the tissue is never strong enough for the ear piercing to be functional again,” he says.

So, how do you avoid the whole piercing-stretching situation? If you notice your ears always hurt with heavy earrings, your earlobes might be on the thinner side. “If you go to an event and put your hair up and wear big earrings, that’s fine—but if [you have thin earlobes] I wouldn’t wear them every day,” he says.

Even if your ears can handle a pair of heavy earrings, Goldenberg still recommends giving your piercings a break every so often: Take your earrings out when you sleep at night, and don’t wear weighted earrings when you’re exercising. “If you’re running or jogging, that gravitational force as you’re going up and down is going to be exacerbated in that area, so you’re more likely to stretch out your earlobes over time.”

You can watch Dr. Lee’s earlobe repair video below. Warning: It is graphic.

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