The Earfold implant system for the correction of prominent ears: lessons learnt from the combined experience of two UK aesthetic surgeons

Abstract

The Earfold implant system, made from a nickel-titanium alloy, is deployed and bends auricular cartilage to address an underdeveloped antehelical fold. The purpose of this study is to report the early results and technical tips from two UK plastic surgeons implementing the Earfold system into their aesthetic practice for the first time. A retrospective review of all patients who received Earfold implants between February 2017 and August 2018 was undertaken. This was a consecutive series in two separate UK clinics. Demographics, clinical outcomes and complications were collected from electronic patient records. A total of 79 implants were used in 36 patients, with 82% (n = 31) placed bilaterally. Mean age was 35 years (56% female). Overall complication rate leading to implant removal was 22% (n = 8). Indication for implant removal included skin erosion (n = 3); implant visibility (n = 2); chronic pain (n = 2) and undercorrection (n = 1). Three patients who had implants removed had previously had an otoplasty procedure. Seven complications (88%) occurred in the first half of Earfold cases performed. Mean follow-up time from surgery was 19 weeks (range 4–58). The Earfold implant system gives reproducible results that can be visualized by patients prior to surgery, and is becoming increasingly popular. Our results highlight a learning curve with the device, leading to revision of seven cases in the first eighteen performed by both surgeons. Therefore, we advise careful patient selection, in particular a history of previous otoplasty procedures, when starting to use the device. Level of evidence: Level IV, therapeutic study.