I Had MACS FACELIFT but my Left Earlobe Look Depressing? (photo)

I had a face & neck lift in December 2012. The position of my earlobe has changed. Time pass and it get worst. My left earlobe is very stretched and is attached to my neck. I need your advise what I should I do? Please check the pictures attached.

Doctor Answers 25

Pixie Ear Deformity following MACS Facelift

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Getting earlobe positioning right, so that the lobe looks natural and looks the same as prior to surgery is one of the most difficult things to get right during a facelift surgery.  The skin around the ear has to be very carefully trimmed during surgery and, although there are various techniques for ensuring this, I tend to compensate for the inevitable relaxation that will occur during the first year following a primary facelift by positioning the lobe higher initially than we want it to end up.  This can be improved in two ways.  One way is to surgically adjust the position of the attachment by surgically detaching the lobe where it attaches, suture it in place higher, then close the area where it used to attach.  However, this would leave at least a 1/2 inch scar below the earlobe.  The more cosmetic but more difficult method is to basically do a "necklift" on the side by releasing a good area of skin behind the ear, all the way up to the hairline and below and anterior to the earlobe and pull all this skin upward.  The earlobe will be pulled up with the skin and can be surgically repositioned will no obvious scarring below.  This is a big procedure for a seemingly small problem, but is, in my opinion, the best option in this case.  However, depending on the amount of tension in the skin at present, the surgeon may find it difficult to pull the skin up very far, and this might make the involved side tighter than the other side, which means that at some point in the future (or at the same time) the other side of the neck might have to be elevated as well to maintain cosmetic symmetry.  It's a tough problem.

Madison Facial Plastic Surgeon
4.4 out of 5 stars 36 reviews

Pixie Ear Deformity following MACS Facelift

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Thank you for your question. Your photos depict "pixie ear", which is unfortunately a common finding following a poorly executed facelift. The "pixie" ear deformity can be recognized by its "stuck on" or "pulled" appearance, which is caused by the tension involving the facelift cheek and jawline skin flaps at the earlobe attachment point. In many cases, this deformity may be improved in the office using local anesthesia. In more severe cases, a revision facelift may be advisable. If only one ear is affected, then a procedure may be limited to that ear without affecting the other ear. Consult with an experienced facial plastic surgeon to better understand the options available in your particular case.

James M. Pearson, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 137 reviews

Pixie ear

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Unfortunately you have developed a pixie ear deformity. This usually happens when the skin that is sown back to the ear lobe is under a lot of tension. The way to correct this is to have another surgical procedure. The good news is it can be done under local anesthesia. Good luck.

Stephen P. Smith, Jr., MD
Columbus Facial Plastic Surgeon

Earlobe distortion after a facelift

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When a facelift is performed by an experienced and talented surgeon there should not be any significant earlobe deformity.  This is true for a full facelift or for a so called “short scar” facelift.  There are many tell tale signs of a facelift, but a “pixie ear” is one of the more obvious.  This deformity can be corrected with a another surgical procedure.

Boris M. Ackerman, MD
Newport Beach Plastic Surgeon
4.8 out of 5 stars 62 reviews

Pixie Lobe deformity

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Dear Pivelia,

Thank you for your question. I am sorry for your trouble, but you have what is called a pixie ear deformity. The name comes from the caricature drawings in cartoon fairies. This can be corrected, but it will require an additional surgical treatment.

Be healthy and be well,

James M. Ridgway, MD, FACS

James M. Ridgway, MD, FACS
Bellevue Facial Plastic Surgeon
5.0 out of 5 stars 98 reviews

Distorted Earlobe Post Facelift

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Hello Pivelia- Regardless of what type of facelift has been performed, it is always a challenge to inset the earlobe just right. Despite our best efforts, the earlobe can be distorted by the eventual relaxation of surrounding tissues. Your earlobe appears like it would benefit from a revision and accept a smaller longitudinal scars that would extend down your jawline.  If there is some extra skin along your neck, you might benefit from a full facelift where the skin and underlying SMAS is pulled more posteriorly. This would help reduce how much of a scar extends down your jawline. Good luck to you.

Mark Anton, MD, FACS
Newport Beach Plastic Surgeon
4.9 out of 5 stars 38 reviews

Macs lift / pixie ear

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That is called a pixie ear.  Can happen with any facelift.  To avoid this need very precise skin tailoring during the earlobe inset and fixation of the skin at the junction with the lobe down to the deeper / firmer structures/.  Can be fixed but will leave scars at that location.  In my opinion the scars would be better than the current appearance.

Adam Bryce Weinfeld, MD
Austin Plastic Surgeon
4.9 out of 5 stars 62 reviews

Revise your ear lobe

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and you should ask your surgeon about it since your surgeon had a direct role in how it turned out.  If your surgeon is as interested as you are in achieving the best possible results, your surgeon should be willing to work with you on making it better. 

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Depressed Earlobe after Facelift

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It is unfortunate that your earlobe was pulled down as during your facelift. As soon as the skin laxity is adequate, the lobe should be revised and the skin elevated so you do not have to rely on hair styling to hide the appearance of your ear.  

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Pixie Ear after facelift

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Such a pulled down and elongated earlobe is also known as Pixie ear deformity, a rare but known problem after face lifting.  There are various surgical options for repair. Now that 9 months have passed you could go ahead with this. Talk to your facelift surgeon to see if he has experience with such a corrective procedure. 

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon
4.6 out of 5 stars 48 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.