Can distorted ears after necklift be fixed? (Photo)

Question

Five months post op, my ears do not look normal and I cannot wear my hair up. PS is no help...he says they look fine. I want to get rid of the pleats in front of the ears (which I never had before), make the earlobes look normal without the pinch and weird line in the lobe, reattach the left lobe, and restore the smooth contour of the ear cartilage that has disappeared at the tragal notch. Is this possible? What would the procedures be to meet these goals? Thank you so much for any advice.

Bhupendra C.K. Patel, MD, FRCS · Answer

Did you only have a "neck lift" as opposed to a proper face and neck lift which is what most patients need to re-drape facial and neck skin properly and to avoid strange skin folds around the ears???If you only had an incision behind the ears, it is not unusual to see this type of folding around the ear.If you did have incisions in front of the ears and behind the ears, then the direction of re-draping of the skin and deeper tissues would be responsible for these changes.Answer to your question: yes these can be fixed. Most surgeons will wisely wait six months or more so as to not create new scars if they are not needed.Every sensible surgeon takes proper preoperative photographs using a macro lens so that there is no distortion of the face and the related anatomy. It is best to have another set of photographs and clearly show the surgeon your concerns. Again, most surgeons will listen to you carefully, review said photographs, and, at the appropriate time (more than six months after surgery), correct the changes you see.Again, if you only had incisions behind the ears for a "neck lift", this should be a salutary lesson to everyone above a "certain age" who is seeking a neck lift that to get a beautiful result, it is USUALLY necessary to make proper incisions in front of and behind the ears. When one tries to have their cake and eat it, one usually ends up with egg on the face!If, in the off chance that your surgeon is not willing to repair this (very unlikely), then a second opinion will soon sort this out. We always ask patients coming to see us for second, third (and fourth!) opinions to bring their operation reports and preoperative and postoperative photographs.Good luck!Prof. Bhupendra C. K. Patel MD, FRCS

Jeffrey M. Darrow, MD · Answer

Thank you for your photos.  As long as the rest of your result is acceptable to you, correcting the skin pleats and excess should be able to be accomplished using local anesthesia.  It would require opening your old incision, lifting up only the skin in question and tailoring and smoothing the skin as it is inset in the correct position.  If your surgeon won't address the issue, there are other board certified plastic surgeon which you could see.

Scott K. Thompson, MD · Answer

Greetings.  Since the incisions for facelifts typically involve both the area in front of and behind the ears, minor changes in the appearance of the ears and earlobes are not uncommon.  If these changes seem excessive or distracting to you, there are likely small modifications to the incisions and scars that can improve your concerns.  You would need to be evaluated in person in order to have specific recommendations made.Good luck.

John A. Standefer Jr., MD, FACS · Answer

I often tell physicians that I train that the most difficult thing about facelift surgery is getting the earlobes perfect. They are not "stable" to any surrounding structures and are at the whim of any tension from redraping the skin while tailoring the skin during face lift surgery. I always spend extra time to get it back exactly as it was.There appears to be a relatively simple solution to correcting your issues. Elevating the skin in front and at the lower border of the lobes with minor tailoring should solve the irregularity. John Standefer MD

Stephen Weber MD, FACS · Answer

Yes, this can typically be improved. It looks like your incisions were limited to the earlobe and likely the back of the ear which has resulted in the pleating and distortion in front of the ear. Assuming that you are happy with the neck result the issues with your lobes and the pleating in front of your ear can be improved with a limited refinement procedure to remove and smooth the skin in those areas. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Richard W. Fleming, MD (retired) · Answer

If you do have lax excess skin in front of your ears as it appears, this skin can be be partially excised and the remainder used to  improve the tragus and and eliminate the creases in your ear lobe.

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