Can a teenager lose their limited use temple recommend for wearing the smallest gauges there are?
A Bishop is the only person who is authorized to judge and issue limited use recommends for youth. As such only the Bishop for the youth in question can make the call on that.
Now if I were to speculate about a hypothetical youth and his/her hypothetical Bishop, then I could see the Bishop taking gauged ears as a symptom. As such I could see that Bishop wanting to figure out what exactly it was a symptom of, because that could be much more serious.
In the For Strength of Youth pamphlet under dress and appearance we read:
Do not disfigure yourself with tattoos or body piercings. Young women, if you desire to have your ears pierced, wear only one pair of earrings.
Since the main purpose of ear gauging usually is to go bigger, I could easily see a hypothetical Bishop determining that having them is a violation of the Church standards as outlined in For Strength of Youth. The whole point of them is beyond a simple pair of earrings, and more towards disfiguring.
In the end though, the impact on holding a recommend is between the youth and the Bishop, and they should talk about it together.