gms | German Medical Science

Introduction: Auricular displacement and earlobe distortion such as the „pixie ear“ after surgical rhytidectomy are frequent and can significantly diminish the aesthetic outcome. Particularly, occurrence of such complications are more present in in secondary or tertiary rhytidectomy cases. Previously, the authors of this article have published a novel technique to avoid such aesthetic-related complications after primary facelift surgery: the posterior earlobe rotation flap (PERF) and concha-mastoid suspension suture (CMSS).

Methods: A total of 25 secondary or 15 tertiary SMAS facelift surgeries were performed between 2015 and 2018. A combination technique consisting of the PERF and the CMSS was executed bilaterally during each re-facelift procedure (n=80). A retrospective data analysis was conducted (preoperatively and one year postoperatively) using our HIS and a photometric data analysis to assess auricular displacement, earlobe distortion, and hypertrophic scarring.

Results: Postoperative pseudoptosis of the earlobe, also known as „pixie ear“ deformity, was not noted in any of our patients and auricular displacement in 2 cases (bilateral in one patient). Unilateral hypertrophic scarring was observed in 1 patient. The postoperative photometric analysis showed a natural ptosis grade I/II in all patients. The total rate of aesthetic-related complications was 3.75% in our patient cohort (auricular displacement: 2.5%; hypertrophic scarring: 1.25%).

Conclusions: The PERF and CMSS technique has shown to be a valuable tool for correcting earlobe distortion and auricular displacement in secondary or tertiary rhytidectomy cases. Therefore, this method has not only a prophylactic treatment ability. Apart from that, it possesses a strong reconstructive power in order to change tension vectors applied in the face (CMSS) and can be used for successfully addressing aesthetic complications such as pixie ear formation (PERF).