What Is The Best Way To Fix A Pixie Ear Deformity?

Q: Dr. Eppley, I had a facelift which left my pixie earlobes. I had three procedures to fix my pixy ear but it stretches back toward my jaw due to not enough skin or too tight skin. Is there any other technique for my case which you think would work better? The last two ear procedures where done three and one month ago by two different doctors. One doctor cut the skin around the earlobe and the other doctor chose only to cut behind the lobe in order not to push the cheek skin. In both cases I was not satisfied. I have attached two pictures, one before the scar and one the way I am now.. I used to have a small high based ear with square jawline that now I can't see due to bad ear position.

A: The pixie ear deformity is marked by a lack of a definitive separation of the earlobe from the face and an earlobe that is ether elongated or abnormal in shape. In essence the earlobe is pulled down. Usually small local procedures of releasing and tucking the ckin around  the earlobe, while tempting and worth a try, do not usually produce a very satisfying improvement. This is because they do not recruit/move skin to make a separation between the earlobe and the face that stays and the problem quickly becomes a recurrent one. The options are either an earlobe release and reshaping with a resultant vertical scar below the earlobe in its wake or a secondary mini-facelift to move more skin underneath the earlobe for a definitive separation. These approaches will likely be more successful than your previous procedures.

Dr. Barry Eppley