How to Avoid Earlobe Deformation in Face Lift

During the postoperative period following a facelift, caudal extension of the earlobe secondary to pulling of the submandibular tissues can occur. This earlobe shape, often termed "pixie ear", is unnatural, and patients often request its repair. The objective of this study was to design a modified facelift technique that provides natural, aesthetically acceptable, and long-lasting results.

In patients with pixie ear secondary to classical rhytidectomy, we omitted the incision around the earlobe; instead, we interrupted it in front of the earlobe and finished it behind the earlobe, without fully dissecting the earlobe from its base. We then performed all required stages of the facelift: detachment of the cellulocutaneous flap, manipulation of the superficial musculoaponeurotic system, establishment of homeostasis, lifting of the cutaneous flap, and finally suturing of the retained edges of the skin onto the cartilage matrix of the pinna.

The above-described operative technique was used in 24 patients from October 2008 to January 2014. Long-lasting projected results were achieved in each case.

The modified facelift technique described herein can be used to perform facelifts with a pre-existing pixie ear, as well as to prevent the development of pixie ear.