Earlobes sewn to face after facelift/neck surgery. Surgeon states “nothing can be done”. Seeking other opinions. (photo)

14 weeks ago I had a platysmaplasty/facelift in So. Florida by 20-year board certified plastic surgeon to fix prominent vertical neck bands. Happy with my neck, I didn’t expect to see my unattached earlobes repositioned and sewn to my face. At my 2-mos. visit, I reported painful popping/pulling of ears, swelling, numbness, restricted jawline and neck, making it dangerous when driving. Unhappy with my ear changes, my doctor suggested I was unappreciative of being made “pretty”. Need a new doctor.

Doctor Answers 25

Earlobes sewn to face after facelift/neck surgery.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
One of the most telling signs (or stigmata) after a facelift are elongated earlobes, often called pixie or satyr ears. Unfortunately, this happens all too frequently because most surgeons do not realize or know about recently advanced techniques to avoid this stigmata. 

The condition can be corrected by a limited procedure, using local anesthesia, but may entail a small imperceptible scar below and posterior to the ear lobe; however, there are other less invasive techniques to bring back the "J-curve" of the earlobe but an in-office examination would need to be performed.  

Additionally, in some circumstances, a modified revision mini-lift can be performed that will correct the issue and completely hide the scar, but again an in-office examination is needed to assess the laxity of your skin and underlying tissues.

The attached link provides more information.

I hope this helps.

Orange County Facial Plastic Surgeon
5.0 out of 5 stars 74 reviews

Pixie Ear

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
I'm sorry you have had this experience.  What you are describing, and what your photos show is called Pixie ear. For people considering plastic surgery, carefully look at the ears and hairline in the before and after photos. It can be difficult to correct significant changes to the hairline or ears that change shape. 

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

There are options available to revise pixie ears after a facelift and/or necklift, but there is a right time to do them

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thank you for your question. I understand it’s 14 weeks since your last surgery where you underwent a facelift and a platysmaplasty by a 20-year experienced Board-certified plastic surgeon. You describe your earlobes as now being attached and you’re also concerned about some pulling, pain and numbness involving your ears. I also understand that you’ve had a disagreement with your surgeon over the results of your surgery, and now you’re seeking other opinions.

Just a little about my background: I’m a Board-certified cosmetic surgeon, certified by the American Board of Cosmetic Surgery, and a Fellowship-trained oculofacial plastic surgeon. I’ve been practicing in Manhattan and Long Island for over 20 years. Surgery of the eyelids, facelifting, and necklifting surgery makes up a big portion of my practice, so I can certainly give you some guidance on this issue.

The condition you describe is called a pixie ear deformity, where the previously detached earlobe becomes attached and pulled downwards after a facelift and/or necklift. Sometimes when this happens, there is a lot of tension on the earlobe which causes the skin to pull downwards and the earlobe along with it. This can be interpreted as skin shortage.

Pixie ears can be caused by a number of things, but since I don’t know exactly what occurred during your surgery, you can approach this problem in two ways. If the situation is tolerable, you can try to wait about 3-6 months, until the maximum pull has dissipated. After which, if there is enough skin, we will elevate the skin to restore the connection in a way that does not cause any pulling or dragging down, so the earlobes can be reset. Another option, if there isn’t enough skin, is to just detach the earlobe, roll it under to create a detached earlobe look, then close the area underneath, so that the earlobe is nice and defined.

To answer your question, yes, this problem can certainly be addressed, it’s just a matter of choosing the right option for you. I suggest giving your original surgeon a second chance and trying to talk to them again, as it would be a shame to let your relationship sour over an issue that can be easily managed. Your original surgeon is also already familiar with your situation, your skin, and if they’re willing to address this issue, it would be better for you to go to them rather than give up after 14 weeks. Admittedly, not all surgeons have the best interpersonal skills. However, if there is still too much friction or animosity, and if your surgeon is still unwilling to acknowledge the issue at hand, then I would recommend meeting with other doctors. I hope that was helpful and I wish you the best of luck!

This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.

Amiya Prasad, MD
New York Oculoplastic Surgeon
4.4 out of 5 stars 80 reviews

Attached earlobes

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

This can be a telltale sign after having a face lift.  This condition, commonly referred to as "pixie ears", can be corrected.  Depending on the draping affect of the sin and the direction of the pull, usually the procedure is a small one which is performed under local anesthesia.  Hopefully, the skin is not closed under tension and this is not part of the problem.  If so, it will require a little bit more of surgery and a proper closure.  I do a lot of revision work on facelifts and correction work and this can be solved in one way or another.  Also, I do many secondary surgeries for improvement of the neck area if it is needed.  The neck should match the face, however, a little more expertise is required for that perfect neck.  Thank you.

Walton Montegut, MD
Newport Beach Physician
4.9 out of 5 stars 47 reviews

Pixie Ears

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
The condition you are describing after your Facelift is known as "pixie ears" whereby all or the majority of the tension in the procedure was placed on the skin.  When the skin is used a the strength bearing layer, the weakest structure available is the earlobe.  The earlobe will elongate and follow the line of tension along the jawline causing a counter clockwise rotation for a relatively more horizontal position.  The best way to correct this problem is via a V-Y closure of the earlobe, or in certain cases a revision facelift where the tension is placed on the SMAS layer.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.9 out of 5 stars 103 reviews

Pixie ears

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
When closing the skin after a face lift it is crucial to check the position and shape of the earlobes, as they are like a signature of the surgeon, displaying his level of finesse and experience. There is a solution for your problem and I don't think that you need to wait much longer. It is a quick procedure which can be performed in local anesthesia in the office.

Best regards

Afschin Ghofrani, MD
Dubai Plastic Surgeon


{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
I see this all this time.  I wish I knew why so many plastic surgeons, who are supposed to be artists, think this looks okay.  It can be fixed, but requires more work than you may think.  The earlobes need to be re shaped and separated from the cheek.  This often involves rearranging the facelift at the same time.  I deal with this when I redo other surgeons' work surprisingly often.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 29 reviews

Pixie ears after face lift

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
This can be corrected surgical by opening up the previous scar and fixating the facial skin to the deep tissue under the ear lobe.  Some type of ear lobe reduction may be needed as they may have become larger as a result of being stretched out.  This is a straight forward fix.

Samer W. Cabbabe, MD, FACS
Saint Louis Plastic Surgeon

Earlobes sewn to face after facelift/neck surgery. Surgeon states “nothing can be done”. Seeking other opinions.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
This is often called "pixie ear" or "Spock ear" and can occur when special attention to proper closure of the ear lobule during facelift surgery. It certainly can and should be repaired.

Correcting earlobe malposition.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Your earlobe position is too far down onto your neck and is correctable.  As with most things in surgery, it is best to wait 6-10 months to let the tissues fully relax and the final resting position declare itself.  While only a face to face examination would tell what would be the best option to correct  this for you, many can be corrected under local anesthesia with minimal external evidence.  As you are not getting satisfactory resolution with your current doctor, seek advice from another board certified 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.