COSMETIC TOWN JOURNAL



Earfold Surgery - An Innovative Treatment for Large Ears

Posted April 23, 2015

If you have been unhappy to inherit ears that “stick out” from the gene pool of your family, it is likely you’ve thought of ways to hide or adjust them. Otoplasty can give the ears a more natural shape and can positively impact your self-esteem and greatly improve your overall quality of life. The latest technique in the field of ear surgery is called earfold surgery and it is gaining traction in popularity.

Earfold Surgery Explained

This procedure can be performed in less than 20 minutes and claims to offer less discomfort, fewer side effects and a rapid recovery. The results can be seen immediately after the procedure and reports have shown them to be consistent and permanent. Thanks to a pre-fold device, patients can also see the expected results before undergoing the procedure.

The procedure is suitable for adults and children above the age of seven. The recovery time needed after the procedure is relatively short so no bandages are needed and patients can return to work as soon as they feel comfortable. The earfold device (a thin medical grade strip of nickel and titanium alloy) is coated with gold to reduce its visibility and to make it almost undetectable. It was developed by Norbert Kang who is a consultant plastic surgeon based at the Royal Free hospital in London. The device was being commercially produced by Northwood Medical Innovation Ltd before the company was acquired in 2015 by Allergan (the maker of Botox).

Principles behind Earfold Surgery

Earfold surgery works by folding back the ear cartilage through the insertion of the earfold implant. The earfold device is made from nitinol AKA a Shape Memory Alloy (SMA) which is made to remember its shape. After the device is placed in position using an introducer, it is then released and immediately adopts its pre-set shape by gripping and folding the cartilage to give the ear a new shape. The prominence in the ear is reduced by the anti-helical fold action of the device.

Before the procedure, the surgeon clips a “pre-fold” device on the outside of the ear for the purpose of showing the patient what the ear will look like after the procedure. The pre-fold tool is made of the same alloy as the earfold but it can be moved around the ear until the desired shape is achieved. Once a satisfactory shape is attained, the position is marked on the skin. The amount of correction needed determines the number of earfold implants to be used.

How Earfold Surgery is performed

During the procedure, the ear is cleaned thoroughly with an antiseptic solution before a surgical drape is used to cover the ear and create a sterile area to operate. A local anesthetic is injected to numb the area and then a small incision is made in the skin. The skin is lifted away from the cartilage to create space for the introducer so that the earfold device can be positioned and released. Once the device has been placed under the skin, it folds back the cartilage to reveal a new shape with less prominence. The incision is sutured and covered with a small adhesive dressing.

The procedure is currently only available in South Africa, Portugal, Croatia and the UK but it has proven itself to be more effective than traditional techniques. However, being a relatively new treatment method, experts are still questioning its success rate since there are only a limited number of operations to collect data from as compared to other otoplasty procedures.

Traditional Ear Plastic Surgery

Ear reshaping is the most common otoplasty surgery and it is a tried and true method of correcting the dreaded “large ears syndrome” for both adults and children. Ear splinting is mainly used to treat babies under 6 months old and it involves resetting the soft cartilage by using small splints to keep the ear in its new position. On the other hand, ear pinning aims to reshape the ear cartilage itself into a less protruding shape using non-removable stitches or sutures. Both of these techniques can be done as a single procedure using general anesthesia for kids and local anesthetics for adults.

Risks and Limitations of Otoplasty

Though minimal compared to other plastic surgery procedures, there are some risks and limitations to consider before committing to an otoplasty surgery and they include:

  • Scarring - The chances of visible scarring are very limited but, in some cases, there could be scarring that is visible to others. In most cases, scars are hidden behind the ears or within the creases of the ears.
  • Asymmetry - The symmetry of the ear could be affected by the procedure. Asymmetry in ear placement occurs as a result of changes during the healing process. Also, surgery might not successfully correct pre-existing asymmetry.
  • Changes in Skin Sensation - The repositioning of the ears can temporarily impact the sensation of the skin in the ear region. This mostly reduces with time but, in some cases, the loss of sensation is permanent.
  • Problems with Stitches - Stitches used to secure the new shape of the ear can cause inflammation of the impacted area of skin. As a result, additional surgery might be needed.
  • Overcorrection -The procedure can create unnatural contours that give the ear an odd look.

Blood clots can form around the area of incision and may require surgical removal. Numbness might also occur around the ears due to nerve damage. It may take up to a year for normal sensations to return but there is a chance of the numbness being permanent.

Consult with a board-certified surgeon that is experienced in performing earfold surgery or otoplasty to see which procedure is the best choice to produce the desired results.

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