Why is it that the shape of the skin (tragus?) that connects to the ear looks different after a facelift?

For me that is the tell tale sign of work having been done. I have noticed that even Kris Jenner (who I imagine has access to the best of the best in Surgeons) of the infamous Kardashian family has her hair cut and styled to hid that part of her ear.

Doctor Answers 18

Apparently not all surgeons worry about the tragus

but if you place the incision along the edge as many like to do nowadays, it has a tendency to pull the tragus forward so you can see straight into the ear.  The old fashioned way of placing the scar in front of the tragus doesn't distort and the scar usually heals very nicely and is my preferred incision in my facelift patients.  And Bruce, in her interview, shows pixie ears that weren't there when he was an Olympian... had a facelift.

Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Why is it that the shape of the skin (tragus?) that connects to the ear looks different after a facelift?

The best way to conceal the pre auricular scar in females is to create an intra tragal incision. I hope that answers your question. I recommend that you visit the website to see examples of what intra tragal incisions look like.
Ron Hazani, MD

Ron Hazani, MD, FACS
Beverly Hills General Surgeon
4.9 out of 5 stars 289 reviews

How to avoid the "pulled" tragus, "pixie" earlobe, hair loss, wide scars and "windswept" facelift.

Dear Disney21:

Surgical facelifts would be likened to pulling the bedspread and / or top-sheet of your bed up to the head-board and removing the excess material. If the skin is advanced too tight, the skin will ripple or create a wash-board and pull-back from where it was stretched. The visible scar and the under-the-skin scar heal tighter creating a over-done, "wind-swept" or "pulled" appearance. The result of this is:
  • a wider scar
  • poorer healing due to tension and possible the incision opening
  • pulling or shifting of the cartilaginous tragus forward
  • pulling of the earlobe and scar insertion creating a "pixie" effect
  • lifting of the temple hairline, losing the sideburn  
  • and / or adding too much tension on the upper neck hairline creating the telltale wide, red scar.
In decades past, the skin was pulled taught with less lift on the underlying soft tissues. Current best techniques will use the SMAS or fascial layer under the skin to lift and re-suspend the sagging soft tissues of the fat and muscle system underneath without pulling on the skin. The more carefully hidden curved incisions and widely undermined skin will be redraped over the tighter, lifted quilting of the soft tissues underneath provide a softer and more natural tucked-in appearance. In this way, the skin is minimally stretched caringly without tension and obviating the pulled, wind-swept and odder looks of yesteryear.

Thank you for this question as it provide a better insight for the public as to the incision sites and facelifting techniques the surgeon selects for each individual patient. Choose a well experienced, Board Certified Plastic Surgeon or ENT Facial Surgeon in consultation and surgery. 

Dean P. Kane, MD, FACS
Baltimore Plastic Surgeon
4.8 out of 5 stars 82 reviews

Treatment of a pulled tragus and other telltale signs after a facelift- removing the 'done look'

Pulled tragus deformity is a hallmark of the 80's and 90's aggressive facelift surgery.

Along with the pulled tragus, there is often a pulled ear, or pixie ear, or in some cases an elongated earlobe.

Further distortion from a facelift can occur with elevated temporal hairline, and visible scarring behind the ear.

Many patients have a 'high on the side' look, with the skin being excessively elevated on the side of the face, causing a windswept appearance.

Even in some mini lift patients, all of these signs are present!!

Fortunately all of these telltale facelift signs can be very successfully corrected in most patients.  Correction of these deformities is highly technical.  These and other signs of surgery can be minimized or erased by select surgeons whose practice focuses on revision facelift work.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 177 reviews

Why is it that the shape of the skin (tragus?) that connects to the ear looks different after a facelift?

too much skin removed over the tragus or insufficient defatting of the skin sewn over the tragus can make it look un-natural. If the incision is placed in front to the tragus, that can leave a visible scar. Some patients heal better than others but tension is the biggest problem.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews

Ear tragus change after facelift

Management of facelift closure takes skill, time, and care, ingredients that aren't a major part of facelift preparation and plan in many cases.  The tragus represents an opportunity to conceal evidence of facelift, by winding the closure around and behind it with finesse and precision.

Steve Laverson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 46 reviews

Ear lobe after surgery

The ear lobe is the most susceptible to change in shape and appearance after a face lift if the face lift tension and design does not take it appropriately into account.  Various ear lobe issues may arise when the face lift is not planned or executed properly.

All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 162 reviews

Tell tale sign after face lift

3 factors play a role, retro tragal incision, tension free closure and the healing properties of the patient!
jawed Tahery
consultant ENT/Facial plastic surgeon

Jawed Tahery, FRCS
Manchester Facial Plastic Surgeon
4.4 out of 5 stars 87 reviews

Tragal deformation after facelift

There are two general ways in which the tragus can be notably changed and deformed after facelifting. The first would be due to too much tension on the closure such that there is pulling and a widening of the scar. Sometimes the tragus can be pulled away from the plane of the face and 'stick out'. The second can be due to a thickening of the soft tissue over the tragus due to the fact that thicker skin from the center of the face has been moved back to the incision site. When this occurs the tragus loses its definition and it can be a tell tale sign of facelift surgery. In order to prevent such a thing the flap must be meticulously thinned prior to closing.
It is incumbent upon the surgeon to be aware of these issues and ensure that the surgery is done thoughtfully.

Andrew S. Frankel, MD
Beverly Hills Facial Plastic Surgeon
4.3 out of 5 stars 26 reviews

Tragus distortion after facelift

A well-designed and well-performed incision is the key issue. Whether a surgeon performs it retro-tragal or pre-tragal depends on the individual preference but the wound needs to be closed without tension and that is the priority. I have seen unsatisfactory results with both techniques so a skilled surgeon is critical to avoiding that "operated look". As others have mentioned avoiding a pixie ear deformity of the earlobe is also important.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.3 out of 5 stars 6 reviews

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.