Pixie Ear Revision? (photo)

I had a facelift and am left with pixie ears that need a slight revision. What should I expect in terms of scars, stitches, time off work, etc."

Doctor Answers 29

Pixie Ear Revision

In the simplest version of the correction the remnant lobe is advanced upward and the scar area is closed behind that.  This would not require time off from work and could be performed under local. 

Pixie ear after facelift

Thank you for your question. The "pixie" ear deformity can be recognized by its "stuck on" or "pulled" appearance, which is caused by the tension involving the facelift cheek and jawline skin flaps at the earlobe attachment point. In many cases, this deformity may be improved in the office using local anesthesia. In more severe cases, a revision facelift may be advisable. If only one ear is affected, then a procedure may be limited to that ear without affecting the other ear. For the in-office procedure, an incision and sutures are placed near the lower portion of the earlobe. This may be concealed with your hairstyle. Scarring is typically minimal. One may return to work the following day. Consult with an experienced facial plastic surgeon to better understand the options available in your particular case.

James M. Pearson, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 64 reviews

Pixie ears after facelift

This can be repaired in the office or operating room depending on what your goals are and what kind of scars you are willing to accept. Some times a simple office procedure as explained by Dr. Hughes is the way to go first. If you are not happy with this result you can always do a more invasive procedure. Good Luck!

Gregory T. Lynam, MD
Richmond Plastic Surgeon
5.0 out of 5 stars 38 reviews

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Pixie Ear Revision

It looks as if there's a lot of tension on your scars and correction may require SMAS support rather than just undermining skin to reduce tension.  So the more involved the procedure the more downtime. 

Ramtin Kassir, MD
Wayne Facial Plastic Surgeon
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Pixie ear after facelift

This can be corrected under local anesthesia. If done on a friday, you can return to work on monday and most people would not notice anything.

Andres Bustillo, MD, FACS
Miami Facial Plastic Surgeon
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Correction of Pixie Ear Deformity after Facelift

As others have stated, the pixie ear or satyr ear deformity after facelift results from too much tension on the ear lobe (lobule) during closure. This can be avoided by not trimming the skin excessively and by relieving the tension on the closure with a deeper lift. That said, if this does occur during healing, the best way to correct it (in my practice) is to repeat the incisions around the ear and undermine widely. The lobule is then resuspended at a higher point to the deep connective tissue and the skin is closed underneath it.

Evan Ransom, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 71 reviews

Pixie ear after facelift

A pixie ear typically occurs when too much tension is placed on the earlobe during closure of the skin. This type of deformity is relatively straight forward to correct and can reasonably be done under local anesthetic in an office setting. The ear lobe is released and the lobe is repositioned in a superior direction. From the picture that you provided it looks like the scar may still be relatively fresh. You also look like you may have some hypertrophy (thick scar) behind the ear. This can be revised as well. I usually like my patients to wait several months after surgery before any revision is done.

Todd C. Miller, MD
Newport Beach Facial Plastic Surgeon
5.0 out of 5 stars 30 reviews

Pixie ear correction

This should be a fairly simple procedure (provided that your surgeon is experienced) with little/no down-time.

Sam Naficy, MD
Seattle Facial Plastic Surgeon
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Pixy ear revision


This facelift complication is a result of downward skin tension on the earlobe following facelift surgery.  The problem can be corrected with repositioning of the earlobe upward with possible re-suspension of the skin flap or a smaller procedure that leaves a small scar.  Good luck.

Scott K. Thompson, MD
Salt Lake City Facial Plastic Surgeon
5.0 out of 5 stars 66 reviews

"Pixie" earlobe deformity after facelift is easily correctable but also easily avoidable.

Closure of the skin after facelift under tension will distort anatomic features that are not rigid. The earlobe is one such structure that will be pulled down in bland into the cheek destroying the lobe. The tension free closure will avoid this. When it occurs is easily fixed with a small procedure under local anesthesia.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 20 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.