Pixie Ear Revision? (photo)

I had a facelift and am left with pixie ears that need a slight revision. What should I expect in terms of scars, stitches, time off work, etc."

Doctor Answers 30

Ear deformity after facelift

Pixie ear deformity usually occurs because of excess tension on the incision and possibly excess skin removal.  If you are happy with your facelift result, then having a simple advancement of the earlobe upward with closing of the skin under it is all that is needed.  Recovery may have some swelling and bruising isolated to that area but shouldn't require time off.

If you are unhappy with your facelift, then habit it revised a year later and having the pixie ear fixed at the same time would be a better option.  Of course, your recovery would be similar to your precious facelift.


Atlanta Facial Plastic Surgeon
4.6 out of 5 stars 49 reviews

Correction of Pixie Ear Deformity after Facelift

As others have stated, the pixie ear or satyr ear deformity after facelift results from too much tension on the ear lobe (lobule) during closure. This can be avoided by not trimming the skin excessively and by relieving the tension on the closure with a deeper lift. That said, if this does occur during healing, the best way to correct it (in my practice) is to repeat the incisions around the ear and undermine widely. The lobule is then resuspended at a higher point to the deep connective tissue and the skin is closed underneath it.

Evan Ransom, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 113 reviews

"Pixie" earlobe deformity after facelift is easily correctable but also easily avoidable.

Closure of the skin after facelift under tension will distort anatomic features that are not rigid. The earlobe is one such structure that will be pulled down in bland into the cheek destroying the lobe. The tension free closure will avoid this. When it occurs is easily fixed with a small procedure under local anesthesia.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 36 reviews

Pixie Ear

This revision of your earlobe is a relatively easy fix under local anesthesia.  You will not miss ant time off work, but will have sutures for 5-6 days.  Good Luck!

Brian K. Reedy, MD
Reading Plastic Surgeon
4.9 out of 5 stars 145 reviews

Pixie Ear Correction

A pixie ear correction is easy. It will usually include

  • local anesthesia,
  • be done in the surgeon's office
  • require a few sutures and a small bandaid or similar bandage,
  • suture removal in about 5 days.
  • the scar should be small, just below the lobe,
  • you should not need time off work,
  • no swimming or aerobic exercise - usually for 7 - 14 days. Best wishes!

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

Pixie ear revision

A pixie ear revision might be a good idea. If you recently had your facelift, it might be a good idea to allow it to heal and wait 6 months.  

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Pixie Ear Revision

Not only do you have the pixie ear deformity following the facelift you also have scarring around the ear secondary to tension on the previous wound closure. The scars can be removed and normal ear lobe contour established  after elevation and mobilization of the skin around the ear. This can be done with local anesthesia, and the stitches will be in place 5-6 days so I recommend that you take 5-6 days off work if you don't want to share this with others.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 39 reviews

Pixie Ear Revision

In the simplest version of the correction the remnant lobe is advanced upward and the scar area is closed behind that.  This would not require time off from work and could be performed under local. 

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

Pixie ear after facelift

Thank you for your question. 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. For the in-office procedure, an incision and sutures are placed near the lower portion of the earlobe. This may be concealed with your hairstyle. Scarring is typically minimal. One may return to work the following day. 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 131 reviews

Pixie ears after facelift

This can be repaired in the office or operating room depending on what your goals are and what kind of scars you are willing to accept. Some times a simple office procedure as explained by Dr. Hughes is the way to go first. If you are not happy with this result you can always do a more invasive procedure. Good Luck!

Gregory T. Lynam, MD
Richmond Plastic Surgeon
4.9 out of 5 stars 60 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.