How do you determine if you need a revision? Have pixie ears, some lateral lines when I tense mouth, and wide scarring (Photo)

Those of us who perform a lot of facelift surgery can almost immediately spot the work of Surgeons who don't. And your result is in this category. Pixie ears are one of the easiest stigma to avoid in facelift surgery. The degree of hypertrophic scarring suggests excessive tension on the skin during skin closure, another big "no-no" for this particular technique. See a facelift expert.

All of these are excellent reasons to undergo a revision facelift. The best way to treat the pixie ear deformity is to lift the deeper tissues and alleviate the tension on the ear lobule/face skin interface. I would also re-excise those scars behind the ear and re-close them without any tension. Poor scarring in facelift incisions is usually due to excessive skin tension at the time of closure.

Severe Tension was put on the skin when it was sutured back together, thus you had hypertrophic scarring. This is Typical when a facelift is done without properly lifting the "Deep Plane".I would recommend for now to do steroids injections / laser treatments and not venture with haste into another surgery