Correction and Prevention of the Pixie Ear Deformity: A Combined Technique

Area of Science:

• Plastic Surgery
• Aesthetic Surgery
• Facial Anatomy

Background:

• Ear and earlobe deformities are common complications following rhytidectomy (facelift surgery).
• Key causes include excessive skin removal, imbalanced lift vectors, and SMAS (superficial muscular aponeurotic system) tension.
• These deformities can significantly detract from the overall aesthetic results of the procedure.

Purpose of the Study:

• To introduce and evaluate a novel surgical technique for earlobe suturing and ear fixation.
• The aim is to prevent aesthetic complications, specifically ear and earlobe distortions, after facelift surgery.

Main Methods:

• A retrospective analysis of 105 primary SMAS facelift surgeries was conducted.
• A combined technique involving a posterior earlobe rotation flap (PERF) and concha-mastoid suspension suture (CMSS) was applied bilaterally.
• Photometric analysis assessed auricular displacement, earlobe distortion, and scarring, comparing pre- and postoperative results.

Main Results:

• The study observed a low rate of complications: 4% overall.
• Specific complications included pseudoptosis (1%), auricular displacement (2%), and mild hypertrophic scarring (1%).
• Postoperative analysis revealed natural earlobe ptosis (Grade I/II) and a statistically significant reduction in earlobe size (P < 0.05).

Conclusions:

• The modified technique, combining facial flap anchoring with CMSS, effectively stabilizes ear position and prevents distortion.
• It offers improved control over earlobe aesthetic shaping, reducing deformities and scarring.
• This novel approach represents a valuable advancement for improving aesthetic outcomes in rhytidectomy.