What Can Be Done About Behind my Ears for Red Skin, Ridges and Scars, Please, Now I Am 7 Months Post Neck/facelift? (photo)

I have reddened skin, ridges & white scars behind my ears, a very tight scalp & sore tightness around ears. PS attached my lobes but they weren't before. Now I have little pixies & pockets behind which are sore & tight, & they will need a release. He says he did me extra tight for a good result but I think he may have pulled me too tight. The scars have now moved from behind my ear & widened so now I can't wear my hair back. I have still have some swelling & discomfort under chin. Thank you.

Doctor Answers 12

Why skin is pulled tight, the healing process, changes in incisional scars, and options to revise scars and pixie ears

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Plastic surgeons usually pull the skin extra tight because based on their experience, there may be some skin regression as time passes. They also take into consideration the tension and closure of the incision and how that heals. Sometimes, despite the proper closure of the incision, scars become wide and thickened and this can happen in any part of the body, and it can happen in the face.

A maturing process in the skin called collagen remodeling or tissue remodeling happens within a year after surgery. This is an important part of the healing process so that there is enough skin to work with if a revision or any adjustment has to be made. If the skin is too tight, it may be hard to make any changes.

In cases where there is scar formation, it can be camouflaged by one’s hairstyle. Hair follicles can grow out through the scar as time passes by. In addition, you may consider a scar revision or the placement of hair follicles that would address the widening of the scar. A thickened scar may also be treated with the combination of 5-Fluorouracil and a drug called Kenalog that are injected to the area to soften and flatten the scar. However, in cases such as pixie ear deformity, minor surgery is done to tuck the ear back in depending if the patient has enough skin to work with. A combination management during the post-operative period and the maturity point a year after is important to avoid complications such as scars and regression. I hope that was helpful, I wish you the best of luck, and thank you for your question.

New York Oculoplastic Surgeon
4.4 out of 5 stars 80 reviews

What Can Be Done About Behind my Ears for Red Skin, Ridges and Scars, Please, Now I Am 7 Months Post Neck/facelift?

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Dear Spirenot,

thank you for your question and photos.  You seem to be not fully healed yet.  It would be a mistake to go in and try a scar revision on angry looking tissue like that.  Wait until the tissue settles down and a revision can be performed for improved scars.

Best wishes,

Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
4.9 out of 5 stars 42 reviews

Scars after Facelift at 7 months

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You do have some concerning areas.  I would wait till a full year and then a revision can be easily done.  Your left side is more problematic than the right side.  On the left I see areas of scaring that are white and I see some limited hypertrophy areas.  This area has a ways to go before 100% healing.  I feel you will end up with a quite large white area behind your left ear and your earlobe is pulled down into unsaleable shape with visible scar.  The front seems better.  The right ear is better with the front okay but the posterior is red and will develop possibly some white scar.  In addition the earlobe is pulled down on the right .   These kinds of problems, I suppose, can  happen, but basically never occur in the hands of an experienced surgeon who does many facelifts.   Was you surgeon ABPS-FACS credentialed?   You will definitely need revision surgeon and I would wait till you are around 12 months.  At this point it will be easier to do a perfect correction.  Your original surgeon may do this without cost to you?  You may want another ABPS_FACS surgeon to go over your face and ears and advise you.  Remember to pick a surgeon certified by the ABPS and a FACS doctor.   My Best.  Dr C

Scar tissue behind ears after a facelift

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Laser skin resurfacing can be done to soften  and better camouflage the scars. I would wait another few months as you are still having some tightness   Then proceed with surgical revision of the earlobes and the ridges, hopefully the ridges will not need much intervention. 

Dilip D. Madnani, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 104 reviews

Face Scars

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After seven months, you have given enough time for wound healing. A revision here is helpful. Once the scar is excised, the tension can be re adjusted lessening the contracture forces against any nerve tissue that may cause discomfort. The position of the earlobe can be revised at the same time if you want.discuss this with your surgeon. All the best

Scar Revision after Facelift

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Thank you for the question and your pictures. It seems that the incisions around the ears were closed under a good deal of tension. This can give the tightness and discoloration that you are seeing. Wounds/incisions will remodel (change in texture, thickness, color, etc.) over about a year post-op.  I would recommend waiting until your 12 month visit and then considering a scar revision.

Wait until healing is complete before considering a scar revision.

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The wounds are still biologically active in will change. It looks as though the band might require a scar revision but I would advise against it until healing is complete.

Scars After Facelift

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While the scars are pink, this indicates your are still in the healing phase.  If a revision is needed, this is usually done a year after surgery.  The "pixie ear" can be revised at any time.  This is usually done in an office or outpatient setting.  Follow up with your Plastic Surgeon as he recommends.  Best wishes!

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 61 reviews

What Can Be Done About Behind my Ears for Red Skin, Ridges and Scars, Please, Now I Am 7 Months Post Neck/facelift? (photo)

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I agree if you have the "pixie" ear deformity than ONLY re operation can correct. But in the views posted I see no pixie on the right view and can not determine if there is one on the left side. As for the red scar issues. Allow more healing/maturation time before considering any additional surgery. 

Scar revision for ridges and scars after facelift with pixie ears.

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Scar revision for ridges and scars after facelift with pixie ears is the best way to correct this problem and re-create a normal looking ear lobe. There must be enough skin laxity in order to do this. See a very experienced facelift surgeon for this revision.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 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.