Abby Lee Miller is famous – or, perhaps infamous – as the iron-fisted dance instructor at the center of the hit TV series Dance Moms.

Week after week, she demanded perfection from her young pupils, reducing some to tears as she relentlessly picked apart every mistake.

But behind the sequins and glittering jewelry, Abby, now 60, was privately fixated on a perceived flaw in her own appearance – her earlobes.

After getting her ears pierced age 10, she says she became instantly 'obsessed' with earrings. Her collection quickly swelled to more than 500 pairs – two pairs of each because she'd always lose one.

'I always had big earrings so you could see them because I have a lot of hair,' says Abby, speaking exclusively to the Daily Mail. 'My hair's dark around my face so, if I wore little earrings, you'd never see them.'

Growing up, she says she noticed her mother, also a fan of big earrings, started to complain her earlobes were sagging, but ignored her. Then, as Abby grew older, she noticed the same thing was happening to her. 

'My mother used to complain about her ears all the time and always wanted earrings that covered her earlobes,' she said. 'I really didn't until recently, in the past six months. I thought, "Oh my god, it's happening to me!".

'I started noticing I was trying to buy earrings that covered the flat part of my ear because I thought, "I'm getting crepey skin, and the holes in my ears are getting too big".'

She adds: 'They just looked droopy. I have good ears, they're flat against my head, they don't stick out. Then all of a sudden I got droopy earlobes.'  

From our mid-20s onwards, the body gradually produces less collagen and elastin – the proteins that keep skin firm and springy. 

Over time, skin loses its structure and begins to sag.

The earlobes are no exception. Sun exposure, gravity and the gradual loss of collagen and fat leave them thinner, looser and more crepe-like, while years of wearing heavy earrings can stretch them further. 

Some studies suggest earlobes lengthen by up to 35 percent between the ages of 30 and 60. 

In women, the process often accelerates after the menopause as falling estrogen levels speed collagen loss.

In the US, plastic surgeons carry out about 5,000 cosmetic ear surgeries, or otoplasties, every year, according to data from the American Society for Plastic Surgeons. 

These are almost always for repairs to the ear, however, due to injuries caused by tears from earrings or bites from animals, such as dogs. 

In some cases, surgery is used to shorten stretched or aging earlobes. The procedure involves removing a small section of tissue before stitching the ear back together, leaving patients with a wound that can take a week or two to heal and, in some cases, a visible scar.

For years, it was the main option for people wanting to rejuvenate their earlobes. But plastic surgeons say a far simpler alternative is now growing in popularity.

The treatment, which costs about $1,000, takes less than 10 minutes and requires virtually no downtime, uses dermal filler to restore lost volume rather than removing tissue.

It was during a routine Botox appointment that Abby first admitted to her plastic surgeon she had become self-conscious about her elongated earlobes after trying to ignore them for six months.

Expecting to be offered surgery, she was surprised when her Beverly Hills plastic surgeon, Dr Patrick Davis, suggested filler instead.

'I noticed it myself,' she says. 'When I went to the doctor, I said, "I'm thinking about this ear surgery." He told me it would leave a scar and involve cutting away tissue.

'Then he said, "I could just put some filler in." I was like, "What?" Literally ten seconds and it was fixed.'

In the procedure, known as earlobe rejuvenation or a lobe lift, doctors inject around half a milliliter of hyaluronic acid filler into each earlobe. The gel restores lost volume, plumping the lobe and reducing its sagging, wrinkly appearance.

'It's the same principle as lip filler,' says Dr Davis. 'The filler attracts water, gradually giving the tissue more volume.'

Patients have the filler injected into the ears in one to three injections. Anesthetic is applied, but the procedure is generally not reported to be painful. 

And the effect is instant. Patients are able to return home that same day and go back to their daily lives. There is no downtime.

Typically, the filler lasts for about two years before needing to be 'topped up'.

'The ears are often an overlooked part of the face,' Dr Davis, who specializes in facial plastic surgery, says. 'And many patients simply are not aware that there is a procedure for earlobes. 

'If someone's in their 60s, this procedure can take about a decade off the earlobes – depending on the person – which can help to make them look rejuvenated alongside the rest of the face.' 

Dr Davis claims there a few downsides. Patients are still able to insert earrings into their ears. 

In rare cases, however, the injections may lead to an infection or can cut off the blood supply to part of the ear if a blood vessel becomes blocked. In these cases, the earlobe will appear white and be cold. It requires immediate medical intervention.

It is not clear how often patients are receiving filler into their earlobes, but Dr Davis says that it is a growing area of his practice.

He currently treats three to four patients a month with the procedure – often women in their 60s who have worn heavy earrings for years.

Abby came in for the procedure about a month ago and was thrilled with the results. 

'It fixed it,' she says. 'It took minutes. It was painless too. It didn't hurt at all, I was shocked. I love the results.'  

For Abby, after her earlobes were anesthetized, she received three injections of filler into each. Moments later, she walked out with 'refreshed' earlobes.

She is so thrilled with the results that she is actually looking to get more filler added to her earlobes.  

'I'm going to have two more injections put in,' she says. 'We played it very safe – we did a little bit to see if it would work, and it did. 

'So, now I'm going to get a bit more done.'

After revealing she had the procedure, Dr Davis claims at least two more women had come in asking whether he could do the same to their ears.