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An Often Overlooked Component of Facial Beauty

By Dr. Jonathan Hoenig

Not many people notice aging or aesthetic changes of their earlobes, but subtle differences in shape can create a dramatic effect on the overall beauty and composition of your entire face. A dead giveaway of a bad facelift is pulling or stretching of the earlobes. Other unwanted earlobe changes include sagging of the earlobes from aging or earrings, stretching or tearing of the ear piercing, thinning of the earlobes, and creases or folds in the earlobes. king tut

Earlobe contour and position play a vital role in facial aesthetics. Did you know that the use of earrings dates back as far as 3500 BCE? Ear jewelry and adornment has been present in all cultures throughout the world for thousands of years. Many of the ancient Egyptian mummies were found to be wearing earrings, and numerous references to earrings are even found in the bible. Today in many parts of the world, particularly Africa, the earlobes are purposely stretched and elongated with jewelry for adornment.

To understand what makes an attractive earlobe in our Western society, we should first take a look at the anatomy of the earlobe. The earlobes are composed of 2 portions - an attached upper part and an unattached lower part. There is significant variability in the shape and contour of the earlobes. Ideally, the earlobe should comprise about 20% of the length of the ear. The average length of the lobe itself is about 18 mm. Most people are born with unattached earlobes. About 30% of people have attached earlobes, which represents a recessive gene.

earlobe attachments   earlobe differences

As we age, the unattached portions of the earlobes increase in size. The earlobes also "deflate" by losing some of the fat under the skin. This results an increase in wrinkles and creases. Just like elsewhere on the face, the earlobe skin is susceptible to sun damage. Sun exposure also contributes to wrinkling of the earlobe as well as discoloration.

When planning a facelift it is important to take into account the earlobe length, width and contour. The desired shape and ratio of the attached and unattached portions of the lobe must be discussed by you and your surgeon.

earlobe changes

Older techniques of face-lifting relied heavily on pulling of the skin to achieve a lift. Right after surgery, you might look fine, but because the skin has a tendency to stretch to accommodate tension, over time the earlobe gets dragged down towards the angle of the jaw. Because of the stretching, the unattached portion of the earlobe then becomes attached to the face. This is known as a pixie ear deformity or Devil's ear since it appears very long and pointed. This earlobe configuration is obviously a dead give away for a facelift since this ear configuration does not appear naturally in any culture.

pixie ear deformity

During facelift surgery the goal is to avoid placing tension on the earlobe or the skin surface. This is accomplished by placing sutures deep in the muscle to support the earlobe and avoid pulling on the skin. A facelift in which only skin is removed and underlying structures are not addressed is a recipe for disaster.

earlobe facelift

If the lobe has been stretched or enlarged from aging or earrings, the earlobes can be reduced at the same time as the facelift surgery, leaving you with cute little earlobes that are proportional to the new contour of your more youthful appearing face. Nobody wants old looking earlobes and a young face!

It is best to avoid earlobe deformities in the first place, but if you have already had a facelift and are among those unfortunate who are experiencing distortion of the earlobe, don't despair. The condition is definitely correctable (although much easier to prevent in the first place). If the earlobe is pulled down, correction of the pixie ear does become a challenge. The scarred region around the earlobe must be released and elevated behind the ear. Stitches are placed deep beneath the skin to prevent the cheek from pulling down on the earlobe. The lengthy earlobe can then be shortened. All of this can be done in the office operating room with local anesthesia.

before and after earlobe revision

Even if you do not have a facelift (or if you have already had one), enlongated or large earlobes can be shortened to give them a more youthful appearance. Torn or stretched ear piercing holes can also be repaired. These minor procedures are performed in the office with local anesthesia. Once that is healed (usually after about 6 weeks) the ears can be re-pierced. If your earlobes are not enlarged, but are thin or have creases, they can also be improved with injectable fillers like Juvederm or Restylane, that will plump them back up.

before and after facelift

earlobe shortening

As you can see, earlobe shape does play an important role in the overall aesthetics of the face. To create balance and harmony, be sure to take into consideration those little earlobes. The difference is definitely in the details!


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Dr. Jonathan Hoenig provides the most advanced and innovative techniques in facial plastic surgery and facial rejuvenation today. To learn more about facial plastic and reconstructive surgery, visit us on the web at http://www.la-plastic-surgery.com, email info@drhoenig.com, or phone toll free 866-HOENIG9.

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