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Earfold Implant System for the Correction of Prominent Ears: Early Experience From 2 UK Esthetic Surgeons

Honeyman, Calum MBChB, BSc (Hons), MRCS; Nugent, Nora MBBCh, BAO, BMedSci, MRCSI, FRCSI (Plast); Shoaib, Taimur MBChB, MD, FRCSEd, DMI(RECSEd), FRCSEd (Plast)

Plastic and Reconstructive Surgery - Global Open: August 2019 - Volume 7 - Issue 8S-1 - p 4
doi: 10.1097/01.GOX.0000584208.77847.9b
Aesthetic Abstracts

Nuffield Department of Surgical Sciences, Oxford, United Kingdom

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

INTRODUCTION AND AIMS: The Earfold implant system, made from a nickel-titanium alloy, is deployed and bends auricular cartilage to address an underdeveloped antihelical fold. In 2018, Kang et al1 (the device inventor) published a series of 403 patients treated with the Earfold device, showing acceptable safety outcomes. The aim of this study is to report the early results and technical tips from 2 UK plastic surgeons implementing the Earfold system into their esthetic practice.

MATERIALS AND METHODS: A retrospective review of all patients who received Earfold implants between February 2017 and August 2018 was undertaken. This was a consecutive series carried out in 2 separate UK clinics. Demographics, clinical outcomes, complications, and follow-up data were collected from electronic records.

KEY RESULTS: 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), compared to 10% reported by Kang et al.1 Indication for implant removal included implant visibility (n = 2), chronic pain (n = 2), undercorrection (n = 1), and erosion (n = 3). Three patients who had implants removed previously had an otoplasty procedure, and 1 was a recent ex-smoker. Eighty-eight percent (7/8) of complications occurred in the first 50% of Earfold cases performed. Average follow-up time from surgery was 19 weeks.

CONCLUSIONS: The Earfold system gives reproducible results that can be visualized by patients before surgery and is becoming increasingly popular. Our results indicate higher revision rates than those reported by Kang et al1 but similar to their initial published results in 2016.2 The trend seems to support a learning curve associated with Earfold, and we advise careful patient selection, in particular a history of previous otoplasty, when starting to use the device.


1. Kang NV, Sojitra N, Glumicic S, et al. Earfold implantable clip system for correction of prominent ears: analysis of safety in 403 patients. Plast Reconstr surgery Glob open. 2018;6:e1623.

2. Kang NV, Kerstein RL. Treatment of prominent ears with an implantable clip system: a pilot study. Aesthetic Surg J. 2016;36:NP100–NP116.

Copyright © 2019 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. All rights reserved.