56 year old, Facelift 3 weeks ago. From these pictures, do you think my tragus (both) will re-emerge? (photos)

Hello.  Thank you for your question.  You are only 3 weeks out from your procedure, and it is normal to still have swelling that can obscure the visibility of the tragus.  This should improve over time.  I typically de-fat the skin that is pulled over the tragus to keep the skin flap thin in that area so that the tragus remains well- defined postoperatively.  However, even with those measures, the swelling in the early postoperative period will still make the tragus appear blunted.  It typically takes 2 - 3 months for that swelling to resolve, but you may continue to notice gradual subtle improvement for up to 9 - 12 months.  I would encourage you to be patient with the healing process and it should certainly improve with time.  I wish you the best in your recovery.

By looking at your photos, by the way your incision was planned and closed, the original shape of your tragus will not be back. In order to preserve the shape of the tragus, a very detailed design in the incision and closure of the wound are paramount for preserving the original shape. You will need a second procedure to correct the problem, but you need to wait about 12 months, so the swelling on the area goes away, the scar tissue gets soft and there is a little of extra skin that allows a reconstruction on the area.

You have a good question! One of the tell tale signs of a facelift is the loss of definition of the tragus. With time you should see more definition of you tragus. However, as part of a facelift, skin  that is thicker is brought backwards, replacing the skin that usually exists over the tragus. To compensate for this when I perform a facelift, I "de-fat" the skin that will eventually be overlying the tragus after surgery. This helps simulate the thin skin that is removed as part of your procedure.If you are not happy with how things look after 6 months, you should express your feelings to your surgeon. A secondary procedure can be performed to provide a better definition of the tragus.

The tragus, the soft flap of skin located directly in front of the ear hole, is expected to fell firm and swollen three weeks after a facelift. The normal "blanket" of skin the covers the tragal cartilage, has been replaced by a thicker "comforter." The most significant reason for this is that the skin is swollen. In addition, there is more tension on this skin which trends to flatten the cartilage.During a facelift, great care is taken to preserve the normal cartilage, and to thin the skin that is placed over the tragus. While this does cause more swelling up front, as the swelling resolves, the anatomy begins to look more normal. Some change is inevitable with incisions placed behind the tragus. The majority of facelift incisions are placed where your is to hide the scar. The only alternative is an incision placed in front of the tragus. This does not change the tragus, but the trade-off is that it leaves the scar in a more visible area. Depending on my patients' anatomy, I may recommend one or the other. For now sit tight and let healing continue. It is too early to tell what the final result will be, especially without the benefit of preoperative photos.

Thank you for the question and your photos. This is a common area of concern and can be a "giveaway" that a facelift was performed. That said, you are very early in the healing process. There will be changes in the thickness and contour of the skin in the area of the tragus. In addition, if this particular area ends up being poorly defined, a minor procedure in the office can be performed to thin the skin over the tragus and give more definition. Best of luck and take care!

You are still pretty swollen in this area, so as the swelling resolves they may look a lot better.  In a facelift thicker cheek skin will be pulled over to the tragus. This usually needs to be thinned out to try and match the old tragus skin.  If at 6 months the skin here is too thick, it can then be thinned out.    

Although you are early in your recovery, and your tissues swelling will get better. your tragus appears blunted.  I would wait at least 4 months to let all swelling subside and if this is still an issue, then ask your plastic surgeon if a small revision could be done to better define your tragus.  This can be done under local anesthesia with minimal downtime.  Best of luck.

Not to worry. Your post op swelling is hiding your tragus for now. Once your swelling subsides in the next few months, they will re-emerge. Be patient and kind to yourself as your body heals.Kindly,Kouros Azar

Thank you for your photos. This is a common area of concern and a potential giveaway of a facelift. However, you are only 3 weeks after surgery and there is a considerable amount of swelling still! When you return to your facial plastic surgeon for follow up, make sure to bring up this area to him/her as an area of concern - likely the slightly thicker skin that has been brought over the cartilaginous tragus is just still swollen however, occasionally, if the tragus is in fact blunted and poorly defined, the skin can be thinned in that area to provide better definition with a minor office procedure. I hope this helps!

You still have swelling around your ear and this will typically get more defined as the swelling goes down.  This is a common appearance after having a facelift due to the skin from the cheek being pulled over the tragus.  If it is still bothersome to you after 6 months then a revision can easily be done in the office with local anesthetic.  Take Care.Timothy A. Janiga MD, FACS