In a facelift, how do surgeons ensure that they preserve the intertragal notch of the ear when making the post-tragal incision?

Q. Many surgeons seem to distort the little curved portion at the base of the ear opening (intertragal notch?) when making the anterior ear incisions. Instead of a curve it ends up as sharply pointed V, with a “seam” where the lobe joins the cheek. (I posted some photos of my ears on a previous question.) I understand that to avoid this, some surgeons make a pre-tragal incision, instead of going behind the tragus, although the scar is more visible. How can it be preserved with post-tragal incision? A. The art of facelifting is in the suspension of underlying tissues with the gentle tucking and not-tight redraping of the overlying skin. If the skin over the tragus is pulled too tight, the healing forces of collagen/scar formation will deform the tragus. There are nuances to this which provide better or worse results. I only use a pre-tragal incision when the patient requires the use of earphones, earbuds or hearing aids to reduce the potential prolonged swelling and ear canal and concha deformities necessitating a modification of the hearing apparatus. Discuss this concern at your facelift consultation and obtain other opinions by a Board Certified Plastic Surgeon talented in up-to-date facelift techniques. All the best!  
This information is not meant as medical advice. It is provided solely for education. Our practice would be pleased to discuss your unique circumstances and needs as they relate to these topics.
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