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What is ‘Pixie Ear’ After Facelift Surgery?

When it comes to enhancing one's facial appearance, facial rejuvenation procedures like facelift surgery have gained considerable popularity. These surgeries can help in 'turning back the clock', smoothing wrinkles, and revitalising your overall look. However, while the benefits are appealing, it's important to stay informed about the possible complications that could arise during and after the surgery. One such issue that has caught the attention of many is pixie ear deformity.

The purpose of this article is to provide you with a comprehensive understanding of what pixie ear is, how it occurs as a consequence of facelift surgery, and the available options for its correction.

What is pixie ear?

Pixie ear deformity, as the name suggests, is a specific type of ear deformity that can occur after undergoing facelift surgery. In essence, it is a condition where the earlobe appears to be pulled or elongated downwards, giving it a somewhat 'pointed' look similar to that of a pixie or elf from folklore. To put it in simple terms, imagine a gently stretched elastic band; just as the band elongates under tension, so too does the earlobe in the case of pixie ear.

The visual characteristics of pixie ears are fairly distinct. In a normal setting, the earlobe rests naturally against the side of the face. However, with pixie ear deformity, there is a noticeable tethering or 'pulling down' of the earlobe towards the jawline. This condition disrupts the natural contour of the ear and face, and for many people, it can be a source of self-consciousness or dissatisfaction with their facial appearance.

Emotionally, the impact of pixie ear deformity can be quite significant. Many people who experience this issue may feel disheartened, especially after undergoing facelift surgery with the intention of improving their looks. The deformity can attract unwanted attention and comments, adding an emotional burden to the physical alteration.

How does pixie ear occur?

The development of pixie ear deformity is intrinsically linked to the process of facelift surgery. To understand how this condition occurs, it's helpful to have a basic grasp of the steps involved in a facelift. Generally, facelift surgery aims to lift and tighten the sagging skin on the face and neck. The procedure often involves making incisions around the ears, lifting the excess skin away from underlying tissues, tightening muscles, and then re-draping the skin before closing the incisions.

Now, the occurrence of pixie ear can result from a combination of several factors, often related to surgical techniques and post-operative healing. Here are some of the primary contributors:

Surgical errors or techniques

  • Inadequate tension distribution: pixie ear can develop if too much tension is placed on the skin near the earlobes during the suturing process.

  • Improper incision placement: incisions made too close to the earlobe can contribute to the pulling effect, leading to the deformity.

  • Skin elasticity: older individuals or those with less elastic skin may be at higher risk, as their skin may not 'spring back' as effectively.

Post-operative factors

  • Scar contracture: as the incisions heal, scar tissue forms, which can contract and pull on the adjacent skin, including the earlobes.

  • Inadequate post-operative care: not following the recommended post-surgical care guidelines (or failing to provide the patient with suitable care instructions) can also contribute to complications like pixie ear.

While the above factors may make it seem like pixie ear is a highly likely outcome of facelift surgery, it's essential to note that the risk is significantly reduced when the procedure is performed by a qualified and experienced facial plastic surgeon. These professionals are trained to avoid such complications through precise surgical techniques and effective post-operative care plans.

The importance of choosing the right surgeon

Selecting the right facial plastic surgeon is paramount in minimising the risks associated with facelift surgery, including the development of pixie ear deformity. Your choice of surgeon can make the difference between a rejuvenated facial appearance and a need for corrective procedures, such as a revision facelift.

Qualities of a good facial plastic surgeon

  • Board certification: always choose a surgeon who is board-certified in facial plastic surgery. This assures you that they have undergone rigorous training and examinations, ensuring a high standard of care.

  • Experience and specialisation: look for a surgeon who specialises in facelifts and has ample experience in the field. Their past work can give you a good indication of their expertise.

  • Patient reviews and testimonials: consider what previous patients have to say. Reviews can offer insight into patient satisfaction and the quality of the surgeon's work.

  • Before-and-after photos: most surgeons will have a portfolio of before-and-after pictures. These can be helpful in setting realistic expectations for the outcome of your own procedure.

The concept of revision facelift

Sometimes, despite everyone’s best efforts, things may not go as planned. In these cases, you may need a revision facelift. A revision facelift is essentially a second surgery aimed at correcting issues that arose from the initial procedure. If you do find yourself with a pixie ear deformity, a skilled surgeon with experience in revision procedures will be indispensable for achieving the best possible corrective outcome.

Why your choice matters

  1. Reduced risk: a qualified surgeon will use techniques that distribute tension evenly during the suturing process, reducing the risk of pixie ear.

  2. Informed decision making: a good surgeon will guide you through the decision-making process, ensuring that you're well-informed about the procedure, potential risks, and post-operative care.

  3. Quality post-operative care: experienced surgeons typically offer comprehensive aftercare, further reducing the chances of complications like pixie ear.

Treatment and pixie ear correction

If you find yourself facing the issue of pixie ear deformity after a facelift, the good news is that it is a correctable condition. The path to correction often begins with a thorough consultation with a qualified facial plastic surgeon. Here, we'll explore both surgical and non-surgical avenues for correcting pixie ear deformity.

Consultation process

Before proceeding with any form of treatment, a comprehensive consultation is essential. During this meeting, your surgeon will:

  • Evaluate the severity of the pixie ear deformity

  • Discuss your medical history and any previous surgeries

  • Recommend the most suitable treatment options for your specific case

Surgical correction methods

In most cases, surgical intervention is the most effective way to correct pixie ear. The corrective surgery typically involves:

  • Releasing the tethered skin that causes the downward pull on the earlobe

  • Redistributing tension evenly across the surgical site

  • Reshaping the earlobe to give it a more natural appearance

Surgical correction is usually an outpatient procedure and can be done under local anaesthesia. The recovery period varies but generally is not extensive.

Non-surgical correction methods

For those hesitant to undergo another surgery, some non-surgical options are available:

  • Filler injections: injectable fillers can temporarily improve the appearance by adding volume to the earlobe. However, this is usually a temporary solution and will need to be repeated over time.

  • Laser therapy: some success has been noted with laser treatments that stimulate collagen and can partially restore the earlobe's shape. Again, results are generally temporary.

It's worth noting that non-surgical options are less effective than surgical correction and are generally recommended for milder cases of pixie ear deformity.

Making an informed choice

Your surgeon will guide you through the pros and cons of each treatment option, helping you make an informed decision tailored to your needs and expectations. It's important to weigh these factors carefully, as the choice of treatment will have a lasting impact on your facial appearance.

Contact us

If you have experienced problems following a facelift and think they are the result of negligence, talk to our expert cosmetic surgery negligence team today. Call 0808 120 5136 or request a callback by completing the contact form.

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Mike Saul


Michael Saul is a partner at Cosmetic Surgery Solicitors, where he brings his extensive specialist legal expertise and passion for helping people to the forefront of his work. With a proven track record of success in cosmetic surgery negligence cases, Michael has dedicated his career to providing clients with the highest level of representation and achieving favourable outcomes.

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