Is the Position of Earlobes Changed After Face and Neck Lift?

With all due respect to my other colleagues posting here about how "technically difficult" it is to repair this problem, I first encountered this problem over 20 years ago when seeing facelift patients of other plastic surgeons. The best "fix" is avoiding the problem in the first place via better facelift technique, but there really is a technically "easy" correction when this problem is encountered.The soft, mobile earlobe is a really poor place from which to suspend the facial tissues during facelift and necklift procedures. Unfortunately, many facelift surgeons do just that and end up with "pulled" earlobes, widened visible scars in front of the ears, or even regular "hanging" earlobes turned into attached "pixie" earlobes. I was asked to "fix" these by unsatisfied patients, usually very early after their facelifts, when redoing the entire facelift was neither necessary, nor something ANY patient wanted to do. Frequently their own surgeon had already tried to excise and revise the scar, only making things tighter, and ending up with the same problem, only worse. (Your pulled and blunted tragus and "gun barrel" ear canal is another problem, but for another question.)

Frankly, there is a straightforward solution that I perform under local anesthesia which not only addresses the stretched earlobe, but can restore the normal "hanging" anatomy you started with, and leave a thin, non-stretched scar. This is not some magical trademarked procedure, but it involves securing the facial tissues to the periosteum of the mastoid just behind the earlobe so that the (dermis of the) facial skin is suspended from the mastoid fascia, taking all tension off the earlobe. This also serves to support the facial/cheek skin from a fixed, durable structure (mastoid fascia), making the cosmetic results of the facelift "last" longer.

Ideally, this suspension technique that relieves tension on the earlobe should be done at the time of the initial facelift or neck lift surgery, but it can be done at the time of a revision, and this will solve the problem quite nicely. Those surgeons who want to try this out can call it the "Tholen modification!" (just joking--I truly abhor "named" procedures--I'm certain I'm not the only plastic surgeon who has figured this out.) Best wishes! Dr. Tholen

Thank you for your question. The position of the ear and earlobe should not be appreciably changed following a facelift or neck lift. However, a 'pulled' appearance of the earlobe is unfortunately not uncommon following a poorly executed lift. 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. Consult with an experienced facial plastic surgeon to better understand the options available in your particular case.

When
facelift procedures are well designed the position of the ear lobe should
remain unchanged. Unfortunately when the wound closure applies tension to the
earlobe distortion and displacement are common. This is known as a pixie
deformity. When this occurs the earlobe loses its curved hanging portion and
the lobe blends with the neck.Your pictures suggest the presence
of this type of deformity. Under these circumstances surgical revision is
necessary. In most cases this requires a surgeon who has extensive experience
performing facelift surgery.

This is seen very commonly. It is due to not insetting the ear lobe properly.  The good news is that it can be corrected by resetting the ear lobe but the face skin must be pulled up higher.  I am sure your PS can correct this. Good Luck

Unfortunately you have mild pixie ears. The earlobes position should not change after facelift surgery, but they can if the skin flap is to tight or the ear lobes are not properly sutured. There are methods to avoid this at the time of surgery and it is possible to revise but more difficult if there isn't extra skin to use.

It is amazing how often the earlobe gets distorted following a facelift.  Usually the tension of the cheek is placed against the earlobe dragging the lobe down and forward.  It is simple to avoid and fix.  The earlobe needs to be carefully shaped so there is nothing dragging it down.  In your case the lobe needs to be rounded out and detached from your cheek so you have a detached lobe which looks normal.  Simple to do when you know how.  Unfortunately, much of the facelift also has to be adjusted and redone for it to work right.

Do you remember if you had a full round lobule before the facelift procedure?  The pulled earlobe is unfortunately a complication that can happen after a facelift.  Some people have a pulled or pixie ear naturally however.  It can be fixed by readvancing the facelift and suturing the lobule so that is exposed to no tension whatsoever.

Has the position of your earlobes changed after facelift? It appears so.  Is this supposed to happen?  Ideally no.  There are three features that the pictures show: 1) The plane of the ear follows a slope trending more toward horizontal than found naturally 2) The earlobes are attached to the cheeks, a finding we refer to as "pixie ears" 3) Obscurity of the shield of the ear canal (tragus).  These three findings are usually a result of excessive tension of the skin on or about the earlobe at the time of facelift skin closure.  Can this be fixed? Yes.  However, the optimal way to correct these findings is with a revision Facelift, which allows for redistribution of tension from superficial to deep layers and tension free re-inset of the earlobes.

The positions of the earlobes can be prevented by no putting tension on the skin after surgery. One of the benefits of the deep plane technique is to reduce the skin tension.

Well.  it depends.  I disagree with the last doctor who replied that the position of the earlobes should always be unchanged or it is called a pixie ear which happens more commonly with "mini lifts" and which requires a "Board Certified Plastic Surgeon" to fix.  How silly!  I have seen a number of patients with this problem who have had full lifts from this type of surgeon. That said, good surgeons work hard to give each patient the lift they are seeking with minimal change to their earlobe positions.  Your problems can likely be addressed with a touch up procedure.

The position of your scars following your facelift procedure is quite typical. However, because of their location, these scars as they mature can certainly change the position of your earlobes. This is often anticipated in advance of facelift surgery.

The asymmetry that you are noticing can easily be corrected with a minor surgical touch-up procedure.