Over time earring holes stretch out and can tear, mending these types of injuries can be done in a few different ways. These methods are surgical and should be done by a licensed medical practitioner. Ask your doctor if it is something they can do, or if they can refer you to a surgeon that can. Not every surgeon is going to use the same techniques for closing the wound, but here are a few examples of what could be done.
These are all outpatient procedures that use local anesthesia. The scars from a simple surgery like any of these techniques will typically be barely noticeable to almost invisible. These and any other choices need to be discussed with the surgeon that will be doing the work, together you can find the right method for your ear to be fixed. After any procedure is done you must to be sure you take care of the wound by cleaning it a few times a day and redressing it if necessary, the healing tissue will most likely have some drainage. Your surgeon will give you a period of time to wait before you begin wearing earring again, but as a general rule re-piercing or wearing any earrings should not be done for a few months after the surgery to ensure complete healing and give the scar some time to soften. The average cost for procedures like these is going to be different depending on where you go, and the rates will start to climb with more complicated cases.