Surgical correction of pixie-ear defect without an exposed incision on the lobe

Pixie ear is a condition in which the posterior edge of the helix extends straight down to the cheek-jaw intersection, without sweeping back up anteriorly to form a lobe. It occurs congenitally, but more commonly is a postoperative condition, following facelift surgery. Over the years, a handful of methods have been proposed to restore a normal earlobe contour in patients with pixie-ear defects, regardless of etiology. However, virtually all either result in an exposed scar or have limited or undocumented follow-up. The technique described here, resulting in a hidden scar on the mastoid-facing portion of the newly formed lobe and at the mastoid, behind the lobe, has been performed 26 times, with follow-up as long as 20 years.