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Earlobe Rotation For Prevention and Correction of Pixie Ear During Rhytidecotmy in Asian Patients

Aesthet Surg J. 2026 Mar 11:sjag054. doi: 10.1093/asj/sjag054. Online ahead of print.

ABSTRACT

BACKGROUND: The most common deformity of the ear or earlobe appearing after a facelift is the pixie ear deformity.

OBJECTIVES: The purpose of this study was to devise and exercise a method to prevent ear deformity, including pixie ear, when performing a facelift and to correct it if it has already occurred.

METHODS: Extended deep-plane rhytidectomy was performed between January 2017 and May 2024, and 76 patients who had passed 12 months post-surgery were included in this study. Group 1 consisted of 40 patients, who underwent W-plasty of incision and combined Botulinum neurotoxin type A (BoNTA) injection around the incision site. Group 2 consisted of 36 patients, who underwent rotation of the lower earlobe after W-plasty of incision and combined Botulinum neurotoxin type A (BoNTA) injection around the incision site.

RESULTS: In a postoperative comparison between the two groups, Group 2 demonstrated superior outcomes over Group 1 by 8.4% on the right and 8.9% on the left, which was statistically significant (p=0.007, p=0.006).

CONCLUSIONS: Partial rotation of the earlobe is demonstrated as a practical and effective surgical approach to prevent and correct pixie ear deformity.

PMID:41810509 | DOI:10.1093/asj/sjag054

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