Pixie Ear Deformity

The Pixie ear deformity is an unnatural stretching of the earlobe that occurs after a facelift where too much tension is placed on the superficial skin layer. As is common with many old style facelift techniques, the skin is over stretched and secured to the earlobe and as healing occurs and the stretched skin settles the earlobe is pulled and elongated in an unnatural and unattractive way. This is a deformity that is a tell tale sign of having had had a facelift and can be seen readily from across the room. This deformity was a very common problem with the older style facelifts but this is completely avoidable with a deep plane or SMAS tightening facelift. When the SMAS layer is tightened during a facelift, the neck and jawline tighten without pulling any skin at all. At that point in the facelift the excess skin can be rotated up towards the ear with minimal to no tension such that there will no settling of the skin and therefore the scars will be minimal and the earlobe will look normal. I have seen many patients over the years that have had facelifts elsewhere that have resulted in Pixie ear deformities. This is a correctable problem by performing a facelift with SMAS tightening. The earlobe will have to be reconstructed by excising some of the stretched and damaged tissue and then reshaped which is an artistic endeavor but the results can be dramatic and life changing for many people.

There is an alternate method that can be used to correct a Pixie ear deformity that doesn’t require another facelift but this will all leave a small scar in place of where the stretched part of the earlobe was. The procedure is known as V-Y plasty and this recruits skin from below the stretched earlobe. Most people chose to have a revision facelift procedure instead of the V-Y plasty because when someone has a Pixie ear there are usually other problems associated with their previous facelift that they want to correct as well. The Pixie ear deformity is a completely avoidable problem and I have never had a patient develop one because all of the facelift techniques that I use involve tightening of the SMAS layer which I would strongly recommend to any patient interested in having a facelift.