Is a Revisional Facelift my Only Choice in Order to Repair Elongated, Scarred Earlobes?

I had a midface lift in 11/2012. Without my having been informed of this prior to surgery, my earlobes were detached. Now, more than one year post-op, my earlobes are elongated and scarred after having finally been reattached. My original surgeon has offered to basically pull up the muscle and tissue behind the ear in order to produce a less elongated appearance, yet, to me, that doesn't directly address the appearance of my earlobes. What do you suggest to address this problem?

Doctor Answers 21

Revision Facelift for Earlobe Correction

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     The earlobes may be addressed by redraping the skin flap, performing a variant of a V-Y plasty, or local tissue rearrangement.  Pictures would be helpful.

Repair Elongated, Scarred Earlobes after a Facelift

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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. 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 133 reviews

How do I correct a pixie ear deformity

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A pixie ear deformity usually results from putting too much tension on the skin of the ear lobe when the skin is closed. This can be corrected in the office under local anesthetic. The ear lobe is released and repositioned in the correct spot and closed.

Todd C. Miller, MD
Newport Beach Facial Plastic Surgeon
5.0 out of 5 stars 34 reviews

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Pixie ear repair

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The best approach to a pixie ear deformity is to reperform the lift.  You must have enough laxity of your skin to have this performed.  The cause of the pixie ear is too much tension being placed on your skin.  Therefore it is paramount that your if you have a revision lift to fix your ears, that the lift will elevate and suspend the deeper tissues, not the skin.

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
4.8 out of 5 stars 171 reviews

Pixie ear correction

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The issue you describe is not uncommon when the surgeon does not do specific maneuvers to prevent this.  Revision of the earlobe does not involve a complete facelift revision and can likely be done under local with minimal down time.

Elongated earlobes

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Elongated and Pixie earlobes are the direct result of the surgeon not paying attention to the closure around the earlobes at the time of the facelift.  They can usually be corrected under a local anesthetic which takes about a half an hour.  If the axis of the entire ear is off center, this will require a mini lift to be able to shift the ears back around and have enough skin for closure

Wait at least 1 year to repair earlobes.

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The so called "pixie ear" can occur after even a carefully performed facelift, and can be repaired with a type of mini facelift revision that lifts the skin and tightens the SMAS under the ear resulting in a tensionless closure of the incision. This can be done with just a local anesthetic usually. Good luck!

Change in ears after facelift

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The best treatment for this is to revise the facelift. The issue is timing. You should wait a year or more, to allow the scar tissues to soften and to regain some skin laxity. If done early, the same thing will happen again.

Correction of Elongated Earlobes after Facelift

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You are describing the pixie ear deformity. Because it is a result of paucity of skin in this area, revision surgery is best delayed for a minimum of 1 year.

The scar can then be excised, skin advanced and the earlobe placed in a more natural position.

Alternative correction methods result in scars extending from the earlobe along the jawline - a compromise often not worth it.

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon
4.6 out of 5 stars 50 reviews

Correction of Pixie Earlobe Deformity After Facelift

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Correction of the pixie earlobe deformity ideally requires re-elevation of the facelift skin flaps if one wants a shortened earlobe and good placement of the scars around it. There are other methods to treat it but smaller procedures done just at the earlobe will result in new scars that venture away from the earlobe-face junction. However, each pixie earlobe deformity can be slightly different so posting pictures would help provide an answer unique to you.

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.