Q: Dr. Eppley, I had one of those TV-advertised facelift procedures last year. Having had it done under local anesthesia of which I would not go through again or every recommend, but that is a different story. What I am considerably bothered by are the scars in front of my ears and that my earlobes are pulled down. They never bothered to mention that either of these two issues could ever occur after surgery. I have read that my ear problem is known as pixie ears. What can be done to fix them?
A: The pixie ear deformity occurs after a facelift due to inadequacies in how the procedure was performed. This is what can happen when all the lifting of the skin flaps is supported by the lower part of the ear. Not to soon after surgery the tension on the non-cartilaginous earlobe will result in it being pulled down creating what has been described as a martian or pixie ear deformity. Poorly placed scars in front of the ear and the distorted earlobes often happen from those poorly trained in facelift surgery who does not understand the basic principles of the operation.
There are two basic approaches to correcting the pixie ear deformity. A simple release of the ear and shortening of the earlobe can be done but this will leave a small vertical scar below the earlobe. The other alternative is to readvance the facial skin flaps (repeat facelift to some degree) and tuck the scar up under the released earlobe as well as behind the tragus of the ear. This will reposition all scars into more aesthetic locations which should have been the result of your first facelift procedure.