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 28

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 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 Lynam, MD
Richmond Plastic Surgeon
5.0 out of 5 stars 32 reviews

A couple of general options to correct your pixie ear, but it's a very customized procedure

Pixie ear deformities happen because the skin has a tendency to regress a little bit with any tightening procedure. Fortunately in my practice in face lifting, I rarely have this problem these days, but it’s not like it can’t happen. The issue is really about the amount of skin as well as what shape your earlobe was prior to surgery. If your earlobe was an attached earlobe and the skin pulled down, leading the scar to be widened , then the simplest procedure is to have the earlobe attached and sutured in an inward way so it’s a little bit rounded and the defect is closed. This, however, does leave a bit of a scar.

In my practice, when people come to me with pixie ear deformities, a lot of them came in with very loose skin and over tightening in the lower face. When I lifted the whole skin and I attached the earlobe in a different way, the problem improved and so did their facelift. There is no generic approach to pixie ear deformities, but there is currently a minimally involved approach. This also depends a lot on how far along you are from surgery and it is something to discuss with your surgeon who did your procedure.

There are some basic options in correcting a pixie ear deformity. There is a straightforward, simple procedure, but it involves a certain amount of scarring that can be camouflaged and allowed to heal nicely. There is also a more extensive procedure involving more lifting related to the pixie ear deformity in order to reduce the downward pull on the earlobe.  I hope that was helpful. Thank you for your question.

Amiya Prasad, MD
New York Oculoplastic Surgeon
4.5 out of 5 stars 46 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
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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 62 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 29 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 61 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
4.5 out of 5 stars 16 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.