A minimally invasive alternative to traditional pinnaplasty
What is the EarfoldTM implant?
EarfoldTM is the name of a modern technique used in the correction of prominent ears. It involves placing an implant into a small pocket in front of the ear. The implant is made of a strong but flexible alloy coated with a gold outer layer. The strength of the implant recreates the fold of the ear, thereby bending the ear back into shape.
What is the EarfoldTM implant made of?
EarfoldTM is made of an alloy of nickel and titanium coated with gold.
Due to the materials used, the implant is inert, in other words it does not cause a rejection reaction. This is principally owing to one of the components of the implant (titanium), which has been used in a wide variety of applications throughout the body (eg. dental implants, hip replacements, spinal surgery, Titanium BreatheTM nasal implant for nasal valve weakness) and is well known for its strength and compatibility with human tissues. The gold coating colour blends in well with most skin types, rendering the EarfoldTM implant relatively invisible.
How does the EarfoldTM implant work?
The EarfoldTM implant works by recreating the antihelical fold at the top of the ear which is usually flattened in people with prominent ears. It clips to the surface of the cartilage, placed in a careful pocket beneath the skin, enabling the cartilage to curve naturally.
Why should I choose EarfoldTM over other pinnaplasty techniques?
The main advantages of the EarfoldTM implant are given below:
- EarfoldTM avoids the need for a cut behind the ear
- EarfoldTM can be performed under a local anaesthetic so you will be awake throughout the procedure and will recover faster afterwards
- The EarfoldTM procedure typically takes 15 minutes per ear, in contrast to around 40 minutes for a traditional pinnaplasty
- There is no need for a postoperative head bandage after EarfoldTM
- The Prefold testing implant can be used during the initial consultation to show you how your ears are likely to look after the surgery itself. The position of the prefold can be adjusted during the consultation until the best possible cosmetic appearance has been achieved. This ability of the prefold technique to illustrate how your ears will look following the EarfoldTM surgery is a significant advantage over traditional or other minimally invasive techniques
- Complications following surgery are generally lower than for traditional pinnaplasty
- The procedure is reversible as the implants can be removed at any point in the future
What will happen at the initial consultation?
At the initial consultation, your ears will be carefully examined by your specialist and the reasons for the prominent ears will be discussed and demonstrated to you. The prefold implants will then be placed on your ears and you will be able to see how your ears might look after the surgery itself. This is possible because the prefold implant is almost identical to the actual EarfoldTM implant itself. The position of the prefolds can be carefully adjusted until your preferred ear position is achieved.
Your specialist will take some notes and photographs to document the correct positioning of the implants.
It is usually the case that one implant is sufficient per ear; however some ears require more than one implant to achieve the ear position that is best for you.
In some cases, the implant cannot achieve a perfect cosmetic result. This is also the case for a traditional pinnaplasty and in fact this is a shortcoming of any cosmetic surgery – the impression of perfection is very much down to an individual ‘s own analysis and viewpoint (hence the phrase ‘beauty is in the eye of the beholder’). However, the prefold system allows you to see how the ears might realistically look; even if there are some small irregularities that remain, many people still choose to go ahead with surgery given the advantages of the EarfoldTM technique.
Is EarfoldTM suitable for everyone?
The EarfoldTM procedure is suitable for most people looking to undergo a pinnaplasty. The advantage is that the position of the implant can be adjusted to tailor the degree of repositioning of the ear to a position that you are most happy with.
There is a possibility that after trying the prefold implant in the initial outpatient consultation, you may not be sufficiently pleased with the new shape and position of the ears. In this case, you have not lost anything. It is better to know before hand whether you might not be happy with the eventual results following surgery than to go ahead with surgery and be unhappy afterwards. That being said, people keen on EarfoldTM often still go ahead as the only alternative is a traditional pinnaplasty (or no surgery at all).
There are some reasons why an EarfoldTM implant may not be suitable for some ears. The commonest reason is due to a prominent overgrown cartilage at the concha (middle part of the ear). If this is present, it can be partially corrected by an EarfoldTM implant placed a little lower down, however if the effect is not substantial enough, the other option is to have an open procedure where a stitch is placed from behind the ear to correct the deformity. In many cases, this can still be achieved under local anaesthetic . In some cases however, a general anaesthetic may be required for this.
If you decide after the initial consultation that EarfoldTM is not for you, your only option is then to consider going for a traditional pinnaplasty. The benefits and risks of this will be explained to you during the same consultation.
What does the EarfoldTM procedure involve?
On the day of the procedure, the prefold implant will be placed on your ears and carefully marked to establish the correct positioning of the EarfoldTM implant. After cleaning the ears, a local anaesthetic solution will be injected into the skin on the front of the ear. Once the skin is numb and cleaned again, a small cut is made hidden within the fold at the front of the ear and a small pocket is carefully created. This has to be of a precise size to enable the EarfoldTM implant to fit snugly. Once created, the EarfoldTM implant is inserted into the pocket and deployed so that it grips the cartilage in exactly the right place. The cut in the skin is then closed with absorbable stitches.
What can I expect after the procedure?
Following the EarfoldTM procedure you may experience a small amount of discomfort, for which you can take a simple painkiller such as paracetamol. You should try to keep the area clean and dry, with no water contact for 7 days. It is advised that you wear a head band such as a sports or sweat type band at night for the first 4-6 weeks to prevent the ear from accidentally folding forwards. Also avoid contact sports for 6 weeks.
What are the possible complications?
There are few complications associated with the EarfoldTM procedure. Possible risks include infection around the implant, which is usually treated with antibiotics, as well as a small amount of bleeding and swelling around the incision site. In some cases you might just see the edge of the implant on the outside of the ear but most implants are undetectable.
Dissatisfaction with the end aesthetic result is possible after any cosmetic procedure but it is very much less likely with the EarfoldTM implant compared with traditional pinnaplasty owing to the advantage of being able to predict the eventual position of the ear with the prefold implant tested at the time of the initial consultation. With any implant placed anywhere in the body there is a risk of movement or migration. This is very unusual with the EarfoldTM implant. If it does occur, or indeed if you decide eventually that you no longer want the implant, it can easily be removed under a quick local anesthetic. If the implant is removed after 2-3 years, in many patients the ear remains in its folded position and does not return to its prominent state owing to the presence of scar tissue. However if the EarfoldTM implant is removed shortly after the procedure, the ear is likely to return to its pre-surgical position.