Correction of Severe "Pixie Ear" Deformity after Rhytidectomy with Modified Minimal Access Cranial Suspension Lift

797 imaging: orthopaedics. Salt Lake: Amirsys; 2004. 2. Ushijima M, Hashimoto H, Tsuneyoshi M, et al. Giant cell tumor of the tendon sheath (nodular tenosynovitis). A study of 207 cases to compare the large joint group with the common digit group. Cancer 1986;57:875-84. 3. Altaykan A, Yildiz K, Hapa O, et al. Multifocal giant cell tumor of the tendon sheath occuring at different localizations of the same tendon of a finger: a case report and review of the literature. Eklem Hastalik Cerrahisi 2009;20:119-23. 4. Reilly KE, Stern PJ, Dale JA. Recurrent giant cell tumors of the tendon sheath. J Hand Surg Am 1999;24:1298-302. 5. Ikeda K, Osamura N, Tomita K. Giant cell tumour in the tendon sheath of the hand: importance of the type of lesion. Scand J Plast Reconstr Surg Hand Surg 2007;41:138-42. Amongst these complications, the pixie ear deformity can be recognized by its “stuck on” or “pulled” appearance, which is caused by the extrinsic pull of the medial cheek skin and jaw-line flaps at the earlobe attachment point, the otobasion inferius. Following rhytidectomy, the tension results in migration of the earlobe attachment point (otobasion inferius) from a posterior cephalad position to an anterior caudal position [1]. It is also possible that the pixie ear deformity can be accompanied by other tension-related complications such as a sweeping effect, scar migration, unnatural appearance of the tragus, and a “face-lift look.” In the medical literature, several techniques have been described for correction of this clinical condition. However, disadvantages such as extra scars on the neck or the earlobe and the controversial effectiveness of minimally invasive techniques in severe pixie ear deformities make the correction of this complication challenging to achieve. In this report, we present a case of severe pixie ear deformity after rhytidectomy, which was alleviated with a modification of the minimal access cranial suspension (MACS) lift. A 53-year-old woman presented to our clinic totally dissatisfied with the postoperative result of a previous typical rhytidectomy performed elsewhere one year previously. Her main complaint was the unnatural appearance of the periauricular area. On clinical examination, severe pixie ear deformity and anterior migration of the preauricular scar were noted (Fig. 1). These facelift stigmata were the consequences of a rhytidectomy with overesection of the skin flaps, resulting in distortion of the position of the earlobe, which was attached to the angle of the mandible. With Correction of Severe “Pixie Ear” Deformity after Rhytidectomy with Modified Minimal Access Cranial Suspension Lift