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

I had a face & neck lift in August 2010. The position of my earlobes has changed. I cannot wear my earrings because my right ear peirce is further away from my face than my left ear. The earrings do not hang right and look odd.

My right earlobe is very stretched and is attached to my neck, it is still sore after 8 months. My left ear is a little stretched. I have very little feeling in my face at the sides of my cheeks and around my earlobes. I have scars completely around my earlobes.

Doctor Answers 40

Earlobe position changed after facelift--there IS an easy fix!

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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

Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Earlobe postion should not change after Facelift-fused ear lobe is called Pixie Ear

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Unfortunately your ear lobe was sutured to far down on the cheek and the curve of the lobule or ear lobe was not properly reconstructed. This happens more often with mini lifts and inexperienced surgeons, and is called Pixie Ear or Spock Ear.

It can be repaired but the repair requires an experienced qualified technically good surgeon. Consult a Board Certified Plastic Surgeon who is experienced at Facelift.

Pixie earlobes after facelifts

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Unfortunately, you didn't have the best artwork done on your face as you have a mild pixie ear deformity.  It would have been nice to see your preop photos to see what kind of earlobes you had.  It is possible to fix this, but if done by an inexperienced surgeon and if you don't have some loose skin to work with, the problem can actually be made worse.

Your problem is far more common after branded mini facelifts than properly done full facelifts.

Ear lobe changes after facelift

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Ear lobe position can change after a facelift.  If re-piercing the lobe does not help with earring symmetry then a small in-office procedure can help reposition them.

Ear soreness and numbness after a facelift should gradually resolve during the first year.

Bryan Ambro, MD
Annapolis Facial Plastic Surgeon

Position of Earlobes after Facelift

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It is very important to look closely at the position of the ears and the hairline when reviewing facelift before and after photos.  "Pixie ears" and altered hairlines are giveaways of a facelift and not a result anyone wants.  In your case, a revision surgery should be able to correct the problem. In other cases correction can be very challenging. Take your time slecting your plastic surgeon. 

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Earlobe deformity or problem after facelift surgery

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Your ears show a mild pixie deformity and will require revision to look right.

You also demonstrate a pulled tragus.

These problems are typical and common with minilifts, especially branded minilifts.

Earring position can be precisely done once the earlobe is reconstructed.

Contrary to popular opinion, these problems are NOT easy to fix.  They require extra tissue from the face to be mobilized and the tragus and earlobe to be artfully reconstructed.  If there is not enough tissue to perform this correction, the correction will fail.

The worst thing to do is a "quick fix" by a non board certified plastic surgeon that will result in further utilization of the valuable tissues that would otherwise be needed to reconstruct these problems.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 195 reviews

Earlobes should not change, but can

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In most facelift techniques, the earlobe remains at the same position it was at prior to surgery. Most Facial Plastic Surgeons will agree that the goal is to get the neck and cheek skin tightened and elevated, but to not leave that tightness pulling down on the ear lobe, thereby changing its position or appearance. However, if that principal is not kept in mind, the earlobe can be drawn into a different position when a patient heals from a facelift. This is commonly referred to as a “Pixie Ear” and would require revision surgery.

Manu Gujrati, MD
Palo Alto Facial Plastic Surgeon

"Facelift Ear", "Pixie Ear" - Complication of Facelift Surgery

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The ear and the tissue just in front of it should NEVER be used to suspent the raised facial skin. In performing a facelift incision, extreme care must be used NOT to have the encision in fron of the ear lobule, the hanging round portion where earrings are placed. If this is done, the bottom of the ear will be pulled down and forward. Worse yet, if the incision is placed in front of the lobule, the lobule will end up being stitched to the side of the head, as in your case. This is referred to as a PIXIE EAR.

This will have to be surgicallr released and revised.

Peter A Aldea, MD 

Peter A. Aldea, MD
Memphis Plastic Surgeon

Telltale signs of a facelift

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Unfortunately, this is a common technical error in facelift surgery. It happens simply because the surgeon brings the incision in front of the ear too far down. As the healing process proceeds, and the inevitable "sag back" of the lifted skin occurs, the ear lobe is drawn downward and the  resulting scar ends up at the lowest point and the ear lobe is pulled into a "pixie ear" look.

I can be corrected, but, of course the best plan is prevention. If a patient comes into my office with "attached" ear lobes (where the ear lobe flows directly into the cheek v. the ear lobe hangs down a bit below the attachment point), I counsel the patient that his/her facelift will be best camouflaged by un-attaching the earlobe and leaving the incision as high as possible beneath ear lobe. Thus, as the healing process occurs and the inevitable "sag back" draws down the lobe, the scar will remain above the end of the lobe and the  pixie look will be prevented.

To repair a pixie...I do the same thing, I simply limit the surgery to just around the lobe.

I hope that helps.

Reginald Rice, MD
Folsom Facial Plastic Surgeon
4.3 out of 5 stars 8 reviews

Ear lobe changes after facelift

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Stretching of the earlobes can occur if the earlobes are not properly supported by the suspensions of a facelift.  While I do not have the benefit of seeing the original shape of your ears, the pictures you show and the history your recount are that of a pixie ear.  This can be repaired with appropriate suspension, but it can involve a more involved facelift revision.  I would be happy to provide you a comprehensive evaluation.

Thomas T. Le, MD
Baltimore Facial Plastic Surgeon
4.9 out of 5 stars 62 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.