The earFold is a minimally invasive, local anaesthetic technique for the correction of prominent ears
How much does it cost?
Initial Appointment £160 At the initial appointment Mr Pringle will :
- take a full medical history
- examine the ears
- determine and explain to you the reasons why the ear is prominent
- give a full explanation about the implant and how it works
- explain what is involved in the surgery.
If the ear appears suitable for treatment with the earFold implant Mr Pringle will sit you in front of a mirror and:
- position temporary implants on the outside of the ear to show how the ears will look
- adjust the position of the implants until you are happy with the shape
- take some photographs to show the effect of the temporary implants
- take some photographs to record the position of the temporary implants
- discuss alternative or additional procedures if appropriate
- email you copies of the photographs so you can think about it and, if you wish, discuss with family and friends.
The Operation The cost of the operation depends on the total number of implants used:
1 implant £1549
2 implants £2349
3 implants £3049
4 implants £3549
Prices correct as of October 2018. For latest prices phone 02392 456065
About the earFold
The Earfold is a minimally invasive procedure for the treatment of prominent ears. The procedure is performed under a local anaesthetic and takes about 15 minutes per ear. Post-operative bandages are not required. One of the commonest reasons for prominent ears is the lack of a fold in the ear cartilage. The earfold is a small implant inserted under the skin of the ear, which recreates the missing ear fold. The implant is a very thin, U shaped strip of a 24-carat gold plated metal called Nitinol, which bends the cartilage and holds it in place. It is usually invisible under the skin. Nitinol is a combination of nickel and titanium. Nitinol has been used in cardiac stents and orthopaedic surgery for many years and there are no problems with rejection or allergy. Each ear will need one or two implants (very occasionally 3). A tiny cut is made on the front of the ear, if necessary the cartilage is weakened and then the implant is carefully inserted. The cut is closed with dissolving stitches. One or both ears can be treated
Will I see the earFold results immediately?
Yes. However post operative swelling or bruising may develop which can last for 1 – 2 weeks
When can I resume normal physical activities such as swimming or contact sports?
Swimming 4 weeks. Contact sports 8 weeks.
Is it painful?
There can be some pain for the first 2-3 days. Simple painkillers are usually adequate.
When can I return to work?
The next day if you wish – though there may be swelling or bruising of the ears. This can take up to 2 weeks to settle.
Could I react to the implant?
The implant is made of a combination of nickel and titanium called Nitinol. Nitinol has been used in cardiac stents and orthopaedic surgery for many years and there are no problems with rejection or allergy.
What does the process involve?
An Initial Appointment
3 month Follow Up as required
The Initial earFold Appointment
At the initial appointment Mr Pringle will take a full medical history, examine the ear and assess why the ear is prominent. If the ear is suitable for treatment with the EarFold implant Mr Pringle will position temporary implants on the outside of the skin to show you how the ear will look. The position of the implants can be adjusted to vary the degree of correction until you are happy with the shape. Mr Pringle will then take some photographs to record the position of the temporary implants before removing them. These photographs can be emailed to you so, if you wish, you can discuss the effect with family and friends. If you decide you would like to proceed contact Mr Pringles secretary (02392456065) for an operation date.
The earFold Procedure
When you come for the procedure Mr Pringle will review the photographs from the initial appointment and reposition the temporary external implants and confirm that you are still happy with the appearance of the ears. The position of the implants is then marked. The ear is cleaned and a local anaesthetic is injected. A small cut is made in the skin on the outer surface of the ear and a pocket for the implant is created. If necessary a special technique is used to ‘weaken’ the cartilage. The implant is inserted and the incision closed with dissolvable stitches. The process is then repeated for each implant. Mr. Pringle will take some post operative photographs. You will be given antibiotics to take for 3 days.
Mr Pringle will review your ears after 3 months or earlier should there be any problems.
What are the risks of the earFold procedure?
All surgical procedures carry risks. This procedure is safe and all the possible complications are uncommon.
Infection: Infection is uncommon. If the implant site becomes infected it may settle with a longer course of antibiotics. If it doesn’t the implant will need to be removed but can be replaced about 3 months later.
Displacement of the implant and possible skin erosion: If the ear is knocked or rubbed the wrong way in the first few weeks the implant may become dislodged. A sharp edge will then be felt under the skin. The implant may need to be repositioned or there is a risk that it will erode through the skin. If it does erode the skin it will need to be removed and replaced at a later date once the ear had healed. Skin erosion is commoner in smokers.
Visibility under the skin: The implant is gold plated so is very well hidden under the skin. However sometimes a very slightly raised area may be visible. This is rarely a problem but if it is the implant can be repositioned or removed.
Keloid Scar: A keloid is where the scar from the original cut in the skin thickens and becomes obvious to see. It can be removed and treated with steroid injections but there is a risk it could recur. It is an uncommon complication.
Asymmetry: The ears are often different to start with and it is not always possible to achieve completely symmetrical ears. A slight bit of asymmetry is very common in people and rarely a problem.
Sensitive ears: The ears may be sensitive in the cold or when lying on them. In over 90% of patients this symptom has resolved by 12 weeks.
Lack of long term results: The earfold is a relatively new device so there is no long term data. The implants are made from Nitinol which has been used in cardiac stents and orthopaedic implants for many years without a problem. There is no reason to suspect why there should be any problems with long term implantation and so far implants have been in place for a couple of years without problem. If there is a problem the implants can be removed but the ear may then start to protrude.
Re-protrusion of ears if implant removed: The initial idea was for the implants to be temporary while the ear cartilage remodeled. However it was found that early removal led to re-protrusion of the ear. In adults experience suggests that the implants need to be in place for at least a year to have a permanent effect and even then there may be a small amount of re-protrusion if removed. It is unknown how long the implants need to be in place in order to achieve permanent remodeling of the ear cartilages. It is thought that a child’s ear will remodel a lot more quickly.
Are other procedures required?
Sometimes. If you have a very large conchal bowl an additional procedure may be required to reduce its size. Very occasionally the ear lobe may require repositioning. Mr. Pringle will discuss these issues with you before any surgery.
Is the Earfold suitable for everyone?
No. The Earfold comes in only one size so sometimes it may bend the ear too much, sometimes not enough, sometimes the back edge of the ear will kink, sometimes the cartilage may be too thick. If the main problem is a large conchal bowl the Earfold may not be suitable.
What about after the operation?
- There may be some mild pain for a few days, which can be controlled with simple pain killers such as Ibuprofen or Paracetamol.
- There may be a little bleeding in the first day – just press over the bleeding area with a tissue for a few minutes.
- Try and sleep on your back. You need to protect your ears at night. An airplane neck pillow may help or a headband (not too tight and not for the first 2 days)
- Bruising and swelling is common. Its normally gone by a week.
- You may wash your hair the following day. Try to keep the ears dry but it doesn’t matter if a little water gets on them but do not let the Steristrips get wet. Do not scrub the ears.
- Be very gentle with your ears for the first 2 weeks
- Avoid contact sports for 8 weeks.
- Avoid swimming for 4 weeks.
- The stitches will dissolve and fall out. Do not pull them out. It doesn’t matter if the Steristrips falls off.
- Do not wear earrings for 2 weeks as it increases the risk of infection.
- Be careful with mobile phones. They are often dirty and risk infecting the ear if pressed against it. Clean your mobile phone.
- We advise not smoking before the operation and for 3 months afterwards. Nicotine causes the blood vessels to constrict and interferes with healing.
- You can go back to work as soon as you wish as long as you do not mind people seeing your bruised ears or the job doesn’t involve a risk to your ears being knocked.
Does the earFold implant need to be removed?
No. In adults if the implants are removed within 6 months then the ear is likely to revert to its original shape. Experience suggests that if the implant is left in for over 12 months then some of the new shape will be preserved if the implant is removed. This depends on the age of the patient and whether or not a ‘cartilage weakening’ technique was used. It is not thought to be a problem to leave the implant in long term. However the implant has only been available for a few of years so long term data are not available.
Can the earFold implant be removed if I do not like the appearance?
Yes. If removed within a couple of months the ear will return to its original shape.
What are the alternatives?
• No treatment • Standard Otoplasty / Pinnaplasty (there are many different techniques)
Where is the Clinic?
Consultations and surgery are carried out at The Spire Hospital, Bartons Rd., Havant, Portsmouth, PO9 5NP
Phone Mr Pringles Secretary at the Spire Portsmouth on 02392 456065.