How does one end up with one pixie ear immediately post op? Is it a standard to match sides before finishing the procedure?

The Pixie ear is a very frustrating complication for patients. However, in the hands of a good surgeon, this is very rare. It often is due to taking too much skin from the face or stitching the earlobe in the incorrect place.I hope you get your issue worked out. Typically, it can be repaired. Dr Bonaparte

Thanks for sharing. Pixie ears or pulled earlobes can occur when there is too much tension on the skin. This can be immediate or can occur months after surgery. Immediate post op though there is swelling in the earlobes and distortion from just the bandages so it is normal not to look normal.  Let your face heal and settle and then the earlobes can be assessed after a week or two.  There is nothing to do now as there is swelling and the surgical areas need to heal.  Your surgeon will follow you and best decide to intervene if necessary down the road. Its not worth second guessing the surgery and what he did or did not do. Be assured ultimately it is correctable and is a relatively easy procedure under local.  

A pixie ear deformity is when the earlobe has been pulled down to far and results in a elongated earlobe that looks like it is attached to the cheek too low. Two things can cause this. Either the cheek skin was pulled too tight and not held into position well enough allowing the cheek to spring forward, dragging the earlobe with it. Or, the earlobe was inadvertently positioned too far forward during the closing. Correction depends on how tight the skin along the jawline is. If the deformity is mild, and the skin is even just a little loose, the cheek skin can be lifted and advanced into a better position. No skin should be removed. If the skin is very tight already, the only real option is to lift the loe back up, put it in the right place and repair the cheek with a straight ine closure. This would leave a thin linear scar extending down from the earlobe. 

Bad luck and easy correction if needed.  Assuming you had surgery by a board certified facial plastic surgeon with extensive experience in facelift surgery, I can only imagine that your ear asymmetry could be a swelling artifact related to the surgery itself.  Experienced and very detail oriented surgeons are very obsessed with bilateral symmetry following facelift procedures, and despite this rigorous attention to detail-sometimes post surgical swelling can distort some facial  and ear parameters by stretching tissues and even helping the deeper stitches give way-which occasionally can lead to a so-called pixie ear situation.  Close monitoring by your surgeon can lead to a natural improvement as the swelling subsides, or infrequently a small minor procedure with local anesthesia no sooner that 9 or 12 months out  may solve your dilemma.  Easy fix to your concerns !  Good luck to a new face for you.

Dear PboothThank you for your question and i am sorry that you are upset. Please see your surgeon for follow up. The ear shape is important and a small correction is usually possible just in the office.With Warm RegardsTrevor M Born MD

you never mentioned how close you are from your surgery. There's always sometimes a little asymmetry should not be very significant. Probably at this point there's nothing to do but wait a few weeks or months to see how it looks as you recover. I would follow-through the surgeon multiple times and ask lots of questions.Best Regards,Dr Gartner 

Unfortunately, if you do really have a "pixie" ear, it is difficult to correct. Since it's caused by too much skin being removed from under the earlobe, it can't really be fixed until some skin laxity returns. I'm sorry. Wish that I had better news.

Hello PBooth. I'm sorry your distressed about your ears being uneven. There are many ways to address this and many are simple procedures under local. Pixie ears usually occur when the earlobe is inset completely into the skin, skin needs to be pulled up under the lobe and the lobe allowed to dangle free to fix this. Talk with the surgeon involved. I'm sure they want you to be happy and again it may be simple. Best luck
Rebecca Jackson, M.D.

Symmetry never exists side to side - but a pixie ear happens when too much skin was excised under the earlobe, and in good hands, should not happen.   Unfortunately, it is difficult to correct, until more laxity develops, because there is a shortage of skin under the earlobe.   I'm afraid you are stuck for now.

Facelifts, including secondary neck lifts, must have all the tension of the lift taken up by the deep layer repair before the skin is trimmed from around the earlobe. There should be absolutely no tension on the skin closure. It's important for the surgeon to make sure the first side is not pulled too tightly, which can create a situation in which there's not enough laxity to close the second side without  tension, creating a pixie ear on that side only. This is extra important in a secondary procedure, such as the revision facelift you experienced. The good news is that a mild pixie ear is usually fixable with a minor local anesthetic procedure. It would be best to discuss this with your plastic surgeon.