What Causes The Pixie Ear Deformity After A Facelift?

Q: I am inquiring about the correction of a pixie ear deformity from a previous face lift done two years ago. I have read about so I know what it is. How did this happen and how can it be corrected. My ears really look funny and that is not a good look for someone 55 years old!

A:  The pixie ear is a well known earlobe deformity that can occur after a facelift. It has been described for decades and, while once more common, modern facelifting techniques have largely eliminated this problem.

While folklore pixies are usually cute and even beautiful, they often have distorted facial features. One of those is the elongated earlobe, hence the name pixie ear deformity. If a facelift is pulled up too much (undue tension), there will be some secondary pullback of the tissues later due to gravity and wound relaxation. Since a facelift incision goes around the ear, the earlobe at the lower end of the facelift incision can show how much the tissues have pulled back down. Because the earlobe is the only portion of the ear that is not supported by cartilage, it can easily be pulled downward months later as tissues settle. Since this is a well recognized potential problem, plastic surgeons strive to keep the tensions point on the scalp areas above and behind the ear and not on the earlobe. It is also helpful to not try and pull a facelift so tight.

Correction of the pixie ear is relatively simple. The earlobe can be detached and restored to its normal shape. This will leave a small residual scar below the earlobe but it can be done in the office under local anesthesia. If it has been years and some jowl or neck relaxation has occurred, one can undergo a simple tuck-up facelift and restore the earlobe shape. By relifting some small amount of loose facial skin, there would be no visible scar below the earlobe as it is tucked back up underneath.

Dr. Barry Eppley

Indianapolis Indiana