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

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.

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. 

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.

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.

The pleats can be revised as can the ear lobe.  The right ear lobe does not have a pixie ear deformity.  It is not possible to judge the left from these pictures.  Tightness behind the ears can be due to sensory nerve changes related to the surgery.  These often improve over time.  Redness can be removed with IPL if it does not fully resolve on its own.  Unfortunately, to make a great face lift, the work has to be hidden some where.  That where is often behind the ears.  A through discussion of this issue before surgery generally helps people be prepared for this.  Despite these discussions, some are still disappointed with the compromises related with surgery.  This is why there is a tend to smaller incision facelifts when they are appropriate for a given individual.  

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.

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

It does appear that you have some abnormal scarring behind the ears which may need some attention.  We recommend that you allow for a full year to pass to ensure that you’re healing is complete. At that time you should then consider scar revision surgery and schedule a consult with your surgeon to discuss all your options. “Dr. D”

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. 

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