Pixie ears post facelift?

How common is pixie ears post facelift and are there ways people can reduce their chances of this developing post facelift?

Doctor Answers 16

Pixie ears after Facelift

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The most common cause for pixie ears after a facelift is due to technique related poor incision placements.  With proper expert incision and suturing technique, pixie ear becomes a rare occurrence.  Essentially the majority of pixie ear complications can be avoided when surgery is performed expertly.  A small percentage of pixie ears develop months after the procedure caused by a heavy neck that pulls the ear downward.   Nonetheless, a touch-up revision procedure can resolve the majority of pixie ear problems.

Face lift - are pixie ears common?

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Thank you for asking about your face lift.
  • Pixie ears can occur if the skin trimmed a little too much under the ear lobe and/or isn't sewn up under the ear lobe at the end of face lift surgery.
  • It is easy to correct however - and is done with local anesthesia in the office.
Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

Facelifting #woundhealing #cosmeticsurgery #BOTOX #tmbcosmeticsurgery

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Dear MummyUpliftThank you for your question!  The change in shape of the ears is uncommon.  This happens because of tension and over resection of skin.  It can be repaired - usually after the healing is mature.With Warm RegardsTrevor M Born MD


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Hi.  The appearance of the earlobes that you are talking about is a common mistake in facelift surgery.  It can be avoided be putting tension on the skin in front of the ear and behind the ear and not on the earlobe itself.  A conservative resection of skin beneath the earlobe also helps to avoid this problem.Regards

Pixie ears post facelift

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Hi MummyUplift.  Since facelift incisions are placed in the native crease/junction of the earlobe to the cheek, there should be no change in the shape of the lobe after surgery.  If the earlobes are not distinct and already closely connected, the "Pixie" appearance is more likely to develop.  Additionally, if excessive skin is removed, the closure will be under tension and may pull the lobes forward, resulting in "Pixie" appearance.  This can be revised under local anesthetic after the swelling has resolved.  Be sure to follow your plastic surgeon's instructions on any compression chin straps, limited activity postop, etc.  Best wishes,

Pixie ears

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this type of problem comes from excision of too much skin below the ear lobes. Conservative resection of skin prevents this from happening. 

Sheldon S. Kabaker, MD FACS
San Francisco Facial Plastic Surgeon


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Hello and thank you for your question. The pixie ear deformity is 100% avoidable if good technique is used and no tension is placed on the closure on the inferior point of the ear lobule.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.  The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Pixie Ear Deformity after Facelift is Uncommon, Avoidable and Correctable

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Pixie ear deformity after facelift is a rare complication that most of the time can be completely avoided by not having tension on the skin where the earlobe and facial skin flap meet.  Too much tension pulls the earlobe downward and lengthens it.  Proper technique with placing no tension on the earlobe and setting the earlobe back slightly so it moves just a touch forward into the correct position after surgery is the way it can be avoided.  If a patient has pixie deformity, it can be fixed as soon as 3 months after surgery with a simple in office revision without needing anesthesia.

How common is pixie ears post facelift and are there ways people can reduce their chances of this developing post facelift?

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Pixie ear deformity is a known "complication " following face lift surgery.  Typically it occurs when too much skin is removed and the ear lobe has too much tension.  The result is an earlobe that gets pulled downward and appears tethered to the lower face.  The way to reduce the chance of this happening is during surgery, the surgeon is careful to NOT remove too much skin.  If it does occur then there are procedures to help recruit and advance more skin to the area to correct the deformity.

Pixie ears after facelift

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Pixie ears after a facelift are a relatively uncommon complication with a board-certified plastic surgeon.  They are caused by removing too much skin. The skin tension then pulls down on the lobe and creates the pics here deformity. Pixie ears are prevented by tacking skin down in front of and behind the ear and then removing skin at the air lobe with no tension. Your best bet is to see a board-certified plastic surgeon who is experienced in facial plastic surgery 

Andrew Kaczynski, MD (retired)
Sacramento Plastic Surgeon

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.