Deep indent along the ear lobe - can this be fixed? 5 months post deep plane facelift. (photo)

Question

Had a deep plane facelift 5 months ago. My surgeon (america board certified) did a awful job by creating incision outside of ear lobe crease. Also my ear develop deep indent along the front of earlobe. It is too visible and am so embarrased to go outside the public. I am so depressed. Can this be fixed.

Kenneth D. Steinsapir, MD · Answer

It is an open secret that general plastic surgery residencies provide poor training in facelifts. Facial plastic surgeons get much more training in fellowship.  Plastic surgeons have to overcome this lack of training in order to deliver a consistent and acceptable facelift.  Some do this by completing an aesthetics fellowship after residency.  Some seek preceptorships and other less formal mechanisms to fill in this gap. Others simply hang out their shingle and either figure it out or have their issues. To avoid a pixie ear deformity, an anchor suture is needed to keep the facial skin from tugging back on the ear.  There are well established techniques for this.  While this can be revised, it may be sometime before it would be realistic to do this.  Part of the problem is how much skin has been removed from the face.  It is unlikely that you have enough skin to permit the ear to relax back to a normal location and then closed the gap that will exist at the edge of the face.  Over time, the skin does stretch out and that will eventually create the opportunity to repair this.  In the mean time do what many women do to hide these poorly constructed facelifts with earrings and a change in hair style.

Konstantin Vasyukevich, MD · Answer

Thank you for your question.  Sorry you are disappointed with the results of your procedure.  The indent in front of the ear lobe could be easily corrected with a small injection of hyaluronic acid filler.  The smoothing effect of the filler will last for about a year.  A longer lasting option would be to use fat grafting procedure.  This would be just as effective as temporary filler, and would last for many years.

Sam Speron, MD, FACS · Answer

This deformity is common.  You should see if your surgeon can correct it with an in-office procedure.

Jonathan Kulbersh, MD · Answer

This can be easily corrected with an in-office surgical procedure. I recommend following up with your surgeon. I hope this helps.

Stephen Prendiville, MD · Answer

The "pixie ear" can be corrected through what is known as a "V to Y" closure.  I encourage you to have a discussion with your Surgeon to discuss your concerns and have this procedure performed.

Jeffrey H. Spiegel, MD · Answer

You have what we call a "pixie ear" where the earlobe is being pulled down.  This should be readily correctable so don't dismay.We do this right in the office typically and the stitches stay in one week, but could be removed by your local doctor.

Philip S. Schoenfeld, MD, FACS · Answer

The photo you have provided shows two issues.  The scar has migrated toward the face from the earlobe crease which is likely the result of too much tension placed on the skin during closure.  The second issue has more to do with the deep plane facelift.  The deep crease is the result of a lack of soft tissue present in this area.  The layer of tissue that is normally recruited into this area during the deep plane facelift may have migrated inferiorly.  After you have healed for a few more months your surgeon should actually be able to remedy both of these issues with a "tuck up" procedure limited to that area.

Adam D. Stein, MD · Answer

This is most likely caused by excessive tension placed on the superficial skin closure in that area.  This can definitely be repaired with a relatively minor revision procedure under local anesthesia. Although six months would be the minimum time I would wait before doing this, it will probably be more successful if more time elapses (closer to twelve months) before the revision.  Good luck.

Andrew Campbell, MD · Answer

It looks like the closure around your earlobe was under some tension and stretched during the healing process. This can be corrected with a minor in office revision. At five months, I don't see why this can't be done at any time. Andrew Campbell, M.D.Facial Rejuvenation SpecialistQuintessa Aesthetic Centers

Parker A. Velargo, MD, FACS · Answer

This brings up an excellent point about having a clear and open line of communication with your surgeon. Chances are that he/ she is also unhappy with the appearance of your scar. This is something that can easily be taken care of under local anesthesia and will likely cost you nothing. Although rare with a facelift, undesirable scarring can occur even in the best of hands.

Deep indent along the ear lobe - can this be fixed? 5 months post deep plane facelift. (photo)

Answers (17)

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