Q: Dr. Eppley, I had a facelift several years ago that I am very happy with the results in the neck and jowls. However, it has resulted in my earlobes being pulled down which I believe is called a pixie ear deformity. I have spoken to the surgeon who did the facelift, and he has attempted to fix the ears by putting a suture behind the ear and pulling them up. At least that is what it felt and looked like. The ears came right back down. I understand that another way to correct them may leave a scar on my lateral face where they were attached and at this point I’m not to excited about that. Other than performing a facelift revision, is there another way to fix the ears that is not to extreme?
A: While the simplest and most effective way to correct the pixie ear deformity is a V-Y advancement, that will leave a fine line vertical scar in its wake as you have pointed out. It actually is very small, and one’s concern may be slightly overblown about it, but it is a scar nonetheless. The second best way is to advance the preauricular skin flap up slightly so the face skin can craddle under the earlobe after its release. This is also effective and uses the existing scars inside the ear up into the hairline. You might call this a revision of a facelift, albeit a minor one, but moving the pulled down skin up is the only way to truly correct the earlobe tethering. Just trying to ‘tuck’ the earlobe from behind will never work as it needs skin redistribution in an upward direction.
Dr. Barry Eppley