Thoughts on this mini Facelift. Left with pixie ears. Any suggestions?

Family nanny, age 68. Went in for a mini facelift & an eye procedure. She was left with a pretty poor outcome with both. Another surgeon fixed her eyes. She didn't trust going back to have the original surgeon fix the eyes. My question is, this is what her ears currently look like. As a PA, I do not feel they are aesthetically pleasing nor done correctly. Her surgeon told her she can't get her the "Before photos." Is it appropriate to ask for this to be fixed for the cost of anesthesia?

Doctor Answers 15

Pixie ear deformity

Regardless of the costs, this is a fixable procedure. A revision may include fixing the pixie ear and reducing the size of the earlobes.

Aliso Viejo Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Pixie Ears

Depending on the case, pixie ears can usually be repaired under local anesthesia. If the ear was not like this before surgery then this is usually a simple repair with an easy recovery. Very rarely would another facelift be necessary for this issue alone. 

Jacob D. Steiger, MD
Boca Raton Facial Plastic Surgeon
5.0 out of 5 stars 62 reviews


The pixie ear deformity is often the result of poor fixation techniques during the facelift, if indeed there was no pixie ear prior to the surgery.  Even if there was, it can usually be corrected, if desired, during the facelift.  I personally would repair this under local anesthesia without a charge.  You would have to wait several months for the skin to loosen enough for the repair to hold.
I wold try to find preop photos of yourself that you may have that show normal ear lobes prior to surgery.  It is indeed interesting that your nanny's surgeon doesn't have photos to show you

R. Scott Yarish, MD
Houston Plastic Surgeon
4.4 out of 5 stars 39 reviews

Pixie ear deformity.

This can be repaired under local anesthesia once the skin and scar tissue are loose/soft enough to allow the procedure to be done. General anesthesia is neither necessary nor advisable, and may be a way for the first surgeon to obtain additional funds for what should have been done better in the first place.

I too do not trust the first surgeon, who would have avoided this severe of an ear deformity had the facelift been performed properly in the first place.

Go the route she did with her eyes--have someone else do the earlobe revision and pay for it. The first surgeon was a poor choice, so re-doing the operation without knowing how to avoid this deformity will not be successful, regardless of the cost. Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews


The ears do appear more "attached" however, whether this is different from preop does require comparing the photos.  Some patients have attached ears and that can be a normal look.  Also, if patient does not like the appearance, can be fixed whether this was caused by surgery or not.  Before photos would be helpful and she should be able to request.

James Chan, MD
Portland Facial Plastic Surgeon
4.9 out of 5 stars 58 reviews

Each surgeon sets his/her office policies about cost

There are no set rules for revision. Thus you will have to go by office policies of surgeon who will undertake such revision.

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 23 reviews

Thoughts on this mini Facelift. Left with pixie ears. Any suggestions?

Sorry about her bad experience. My thoughts:

  • The pixie ear is an easy fix in the office under local anesthesia with minimal recovery.
  • She has a legal right to her before pictures as they are part of her medical record.
  • Yes, it is appropriate to raise your concerns to the surgeon but there are no rules about the costs involved

Good luck

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 68 reviews

Pixie-ear deformity following a facelift.

Sorry to hear about her facelift dissatisfaction.  Facelifting, including mini or short-scar facelifts, usually results in a nice rejuvenation of the lower 1/3rd of the face.  The pixie-ear deformity can be the "tell-tale" sign of having had a facelift.  Not seeing the original before pictures makes it harder to talk about revision, but most times the pixie-ear can be improved.  Your surgeon should provide your pictures, and I would be in touch with him/her as they know her circumstance best and want to share in her success and satisfaction.  I would suggest waiting at least 3-4 months before doing a revision, and it depends upon the surgeon, but revisions are generally at much lower or no cost to the patient for surgical fees.  The anesthesia fee is likely still going to be charged.  Best regards.

John R. Burroughs, MD
Colorado Springs Oculoplastic Surgeon
5.0 out of 5 stars 14 reviews

Don't go back to the original surgeon

It is unethical to refuse to show you your before photos.  I would not trust your original surgeon to do the revision.  Your pixie ear is not subtle, it is a sign that he/she didn't know what they were doing.  Yes you should try to get some money back from the original surgeon and then find the most experienced facelift surgeon near you to revise this.  Best of luck. 

Garrett Griffin, MD
Minneapolis Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

Pixie ear repair

It is best to wait a full 6 months at least before considering any type of revision or repair as the skin is still healing and scar tissue may interfere with any 'touch ups'.  I would compare her before and after earlobe pictures and if the pixie ear is obvious, then a repair under local anesthesia is a reasonable request and relatively straight forward to do. Good luck!

Dilip D. Madnani, MD, FACS
New York Facial Plastic Surgeon
4.9 out of 5 stars 89 reviews

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