Ear Deformity? 3 weeks after SMAS Facelift, this is how my ear looks now. I feel its doesn't look "normal". (photo)

Question

Dear Doctors, 3 weeks after smas facelift, this is how my ear looks now. I feel its doesn't look "normal". I believe its shows clear sign of the facelift. If there is any option to fix it? Thank you.

Garrett Griffin, MD · Answer

guitz: whenever doing facelifts, it is important to make the ear as natural looking as possible, and to make sure that the earlobe doesn't get pulled down into an "elf" shape as it heals.  To help prevent the elf shape, surgeons sometimes sew the skin extra high and tight under the earlobe. This may be what is going on in your case.  Give it time...the scars in front of the ear will become less obvious and the ear will look less like it is just stuck on the side of your face.  If after 3-6 months you are still unhappy, your surgeon can revise it, probably in the office.

Ryan Neinstein, MD, FRCSC · Answer

I would like to see your pre op picture. Your scars look great but I do not see much of a tragus but again hard to tell if that is different or not without a preop picture. I would wait a year for your scars to mature before any revisions

Paul F. Vanek Jr, MD · Answer

You are, unfortunately, going to need to wait a few weeks before you have your scar placed into the appropriate position in a retro-tragal scar position that most board certified plastic surgeons would elect to use in the first place. Your immediate post-operative fibrosis and perhaps your skin tension will be such that you will need to wait probably a few months before that incision in the pre-auricular position has reached tissue equilibrium and is soft and supple enough to contemplate a re-elevation of your skin flap and advancement into its proper position. I always counsel my patients against analyzing early results and I would like to make sure I reiterate that with you. I don’t want to cast dispersions but it sounds like you may have been “quickly lifted” and I hope it fits your lifestyle . . . .

Vincent N. Zubowicz, MD · Answer

In an attempt to decrease the length of the incision some procedures try to sit in different lengths skin on either side of that incision. This can result in irregularities on the longer side. Most of the time a revision will be necessary. This revision will demand lengthening the incision.

Kenneth Hughes, MD · Answer

Tragal pointer blunting may be an issue, but this is impossible to evaluate without preoperative pictures.  The scar appears to be well placed as well as the lobe position.

Michael I. Echavez, MD · Answer

At three weeks after your facelift, there still will be additional changes taking place as you heal over more time. I would recommend waiting at least six months from the time of your surgery before considering any revision. Is the issue just on one side or both sides? If it does require revision, it would be a minor procedure that could just be done in the office.

Paul Wigoda, MD · Answer

The good news is your scars look fairly good. The bad news is that there is no definition of the tragus. Most likely you will need a small revision but i would suggest waiting at least 4 to 6 months for things to settle. When performing a facelift, there are quite a few small technical details that will differentiate a great result from an average or poor result. Its important that patients realize that not every facelift is the same and its important that patients do their research and ask the right questions when deciding on a surgeon. Shopping around by price is an error I see frequently as patients assume you get the same procedure no matter who does it.

Steven Wallach, MD · Answer

It looks like the skin was bunched up a bit behind your ear as one issue. The other is that the ear may not have been inset without some tension causing it to pull a bit, a common issue in facelifting that usually can be avoided.

Gary R. Culbertson, MD · Answer

Ear lobe position looks good. Yes, you could require a minor procedure in the future to adjust the tragus. The tragus is the small cartilaginous projection anterior to the external opening of the ear. These procedure are often done under local anesthesia in the office and are considered minor procedures. Please consider waiting at least 3 to 4 months or longer before any further surgery. Best,

	 

	Gary R Culbertson, MD, FACS

Samir Shureih, MD · Answer

the tragus is blunted. It is the attebtion to these fine details that makes the difference.

	It can be corrected and improved, but will require opening the front of the ear scar. All the scar on the tragus should be removed, cut the tragus with a defined curve and suture fixateavove and below. the skin needs to be thinned over the tragus.

Ear Deformity? 3 weeks after SMAS Facelift, this is how my ear looks now. I feel its doesn't look "normal". (photo)

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