Q: Dr. Eppley, I had a facelift several years ago that I am ok with the results in the jowls. However, it has resulted in my earlobes being pulled down which I believe is called a pixie ear deformity. My surgeon who did the facelift has died and a different doctor has attempted to fix the ears two years ago by putting a suture behind the ear and pulling them up. After a week when it healed the ears came right back down. Is there another way to fix the ears that is not too extreme? I have read your web site and I really hope that you can help me. Thank you.
A: A pixie earlobe deformity results after a facelift because the tension on the lifted facial skin has not been properly anchored or supported. This results in elastic recoil of the skin, pulling downward over time on the non-cartilage supported earlobe. This results in it being stretched end elongated. When thinking about what the cause is, it should be no surprise that simple earlobe tuck or suture is destined to fail. The only real way to effectively treat the pixie earlobe is to re-raise the anterior skin flap or perform a more limited form of the original facelift, known as a tuck-up facelift. While it may sound extreme it is nothing like your original procedure and could be performed under local anesthesia. The skin flap needs to be lifted up in front of the ear again and raised up to cradle the earlobe. This will both shorten the earlobe and redistribute the skin forces better so that it does not recur.
Dr. Barry Eppley