Prevention of earlobe deformity in face-lifting

"Pixie-ear" deformity is a postrhytidectomy sequela in which the ear lobe is pulled inferiorly. This deformity may be attributed to excessive skin excision inferior to the earlobe, direct suturing of the facial flap to lobule skin, or excessive scarring. When there is increased tension on the earlobe, the otobasion inferius (cephalic attachment point of lobe) migrates from a posterior cephalic position to an anterior caudal position. The authors present an operative technique to prevent pixie-ear deformity and optimize earlobe position in face-lifting.