I'm 61, had second facelift in May. First one was wonderful, this one I am not thrilled.

On the post op exam the doc says the pixie ears are temporary, will be gone in a year (doesn't sound right.) First one (15 yrs ago ) was a dramatic change, this one almost nothing. Any thoughts?

Doctor Answers 12

I'm 61, had second facelift in May. First one was wonderful, this one I am not thrilled.

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Your second facelift should produce good results (as your original surgery did). Of course you are now 15 years older, and your skin elasticity is not the same as it was at the time of your first surgery. Nevertheless, most patients who were pleased by their original results are pleased with their subsequent surgical results as well. Unfortunately, your pixie ears probably will need surgical correction.


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Pixie ears are not temporary.  You will need surgery to correct this.  Discuss your concerns with your plastic surgeon and consider a second opinion.

Secondary facelift : pixie ears and not thrilled = was it performed by same surgeon? #fb #facelfit #drmesa

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Secondary facelifts (second facelfit) should be able to deliver similar outcomes of a primary or first time facelift. However, since the face skin and soft tissues 15 years a facelift are not the same ( they are aged), the outcome of a secondary facelift could be affected by this new physical finding. 

It is possible that patients may not have same results after a secondary facelift if it was performed by a surgeon different to the one that performed the first facelift.

Pixie ears ( pulling of the ear lobe along the jaw line) after a facelift very unlikely will improve by itself. A pixie ear usually requires surgical correction ( see images in the link below). Pixie ears  repair could be performed wide awake under pure local anesthesia without discomfort or pain in selected patients when performed by a surgeon specialist in facelift under local anesthesia.

John Mesa MD
Board Certified Plastic Surgeon
Facelift Under Local Anesthesia Specialist
New York City (#NYC) & New Jersey (#NJ)

John Mesa, MD
New York Plastic Surgeon
4.9 out of 5 stars 135 reviews

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Pixie ears and facelift

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thanks for your question.  Unfortunately, pixie ears are not temporary and will need repair at some point.  Have a frank discussion with your PS and if you are unhappy, get a second opinion.

Samer W. Cabbabe, MD, FACS
Saint Louis Plastic Surgeon

Second Facelift

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As we age we not only lose the elasticity in our skin but also lose volume in our face as fat and muscle atrophies.  Initial facelifts do well at correcting both by repositioning deeper tissue and tightening skin. Results can be dramatic.  Later in life, a second facelift will be worthwhile but may not be as dramatic or natural looking unless done well. Volume replacement may be more important later in life and fat grafting is a wonderful adjunct procedure done at the time of a second facelift (and sometimes first facelifts as well). In my opinion pixie ears are rarely self-correcting and can be fixed. My thought would be that you should return to your surgeon and discuss fat grafting or other volume replacement if this was not done at the time of your second lift and if it would be helpful. Also inquire as to whether they are willing and able to correct your pixie ears if not gone in a year.

Martin B. Weiss, MD
Boston Plastic Surgeon

I'm 61, had second facelift in May. First one was wonderful, this one I am not thrilled.

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In my experience it is uncommon for true pixie ears to improve with time.  It is best to use techniques that prevent their cause and if they occur the ear should be revised.

The attahced link provides more information.

I hope this helps.

Timothy R. Miller, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 70 reviews

Second facelift result

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Pixie ears will never self correct and only worsen with time as they result from excess scarring around the ear incision.
The photo you have uploaded shows a good result with your jowls and cheek, mid face area. You still have prominent marionette lines and naso-labial folding which can be addressed with dermabrasion and fat grafting.


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Typically, secondary facelift changes are less dramatic. Always depends on the indications and the skill in performing. Nonetheless, if it was truly indicated, you still have desired improvement discussed preoperatively. In my experience, "pixie ears" tend to worsen over the first year, not improve. You have no photos, so I don't know your situation exactly.

First Lift = Best Lift

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Thank you for sharing your concerns with the physician community.  As a general statement, one's first facelift (if performed technicall well) is typically the most dramatic and provides the most overall improvement.  That said, subsequent lifts are usually not as dramatic in nature, although they should still give noticeable results (when comparing the before and after photos of yourself).  Unfortunately, in regards to the pixie ears, they will not magically resolve on their own.  If you have them now, at best they won't get any worse with time.  Please give everything some time to heal over a full year and then readdress with your PS.  Pixie ears are usually not difficult to correct and improve.  They can be fixed in an office setting under local anesthesia.

Facelift revisions

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Thanks for sharing.  A second facelift procedure will generally not be as dramatic as the primary.  That said, it has been 15 years and you should look refreshed after this latest procedure.  Although incisions improve with time, pixie ears usually are not temporary and will likely become more apparent with time.  This can be corrected if need be.  Continue to follow up with your surgeon. 

Raymond E. Lee, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 95 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.