Earfold: What You Need to Know
Pros & cons
How much it costs
What to expect
How long recovery takes
How long results last
How safe it is
Fast facts
Earfold is a small, permanent metal implant that's placed under the skin in the ear cartilage during a minimally invasive surgical procedure, for the correction of prominent ears. This curved, highly elastic implant is made of the biocompatible nickel-titanium alloy nitinol, plated in 24-carat gold. (Nitinol is commonly used in medical devices, including cardiovascular stents.)
Ear pinning with Earfold is an alternative to standard otoplasty surgery, a much more involved procedure with a longer recovery time—but it's not the best option in every case. “It’s an interesting innovation for patients who don't desire a full otoplasty,” says Dallas plastic surgeon Dr. Rod Rohrich. “However, it's useful only for those who have a slight upper-ear prominence, with a lack of antihelical fold definition [the primary ridge of cartilage in the center of the ear, also called the antihelix]. It’s not a viable option for patients with full-blown prominent ears due to a protruding conchal bowl, which is the most common scenario I see.”Â
The procedure also can't make big ears smaller, though it can make them less noticeable.Â
Earfold implants sit close to the surface of the skin on the front of the ear, but as Dr. Walid Sabbagh, a plastic surgeon in Surrey, England, notes “Usually the Earfold is almost invisible. Occasionally it can be slightly noticeable, if it’s not totally flush with the cartilage.” Its 24-carat gold coating also helps make the implant less visible.
Pros
- Earfold can permanently pin back prominent ears. According to the manufacturer, Allergan, it's a suitable solution for both adults and children over age 7.Â
- You'll be able to see options and choose the new position of your ears before the procedure, unlike with standard otoplasty.
- The procedure takes less than 30 minutes, while otoplasty typically takes two to three hours.
- Earfold recovery time is minimal, compared to a more invasive surgical procedure.
Cons
- Earfold is not yet FDA-approved, but Allergan is currently conducting a clinical study to test its long-term safety and performance. It’s also a relatively new device, so data on long-term patient outcomes is scant so far.Â
- There’s a risk of complications that may require medical intervention, including implant removal.Â
- There’s also a possibility that the implant will be visible at the surface of the skin if it's not placed flush with the cartilage, or if it shifts during healing.Â
- You may have some discomfort during recovery, due to bruising and swelling.
- Average Cost:
- $3,939
- Range:
- $250 - $10,000
Your Earfold cost will depend on your surgeon’s level of experience and their practice location.Â
Because it’s considered a cosmetic procedure, Earfold isn’t covered by insurance.
A plastic surgeon with experience in traditional otoplasty performs the Earfold procedure. They’ll begin by using temporary positioners called Prefold, to show you the results Earfold implants can achieve. Once you’ve settled on the best position and number of implants to adjust your ear shape, your surgeon will mark your ears to help guide the implantation, and then inject a local anaesthetic.
When your ears are numb, your surgeon will make a small incision in the skin on the front of the ear and insert the Earfold using a surgical tool called an introducer.
The doctor will close the incision with sutures and cover the area with surgical tape as a temporary protective barrier. The entire procedure takes 20 to 30 minutes.
You'll see your ears' new position immediately following the procedure.
There’s no social downtime associated with the procedure—you can return to work or school as soon as you feel comfortable. Just be aware that your ears will be sore for a day or two and bruised, swollen, and possibly inflamed for about a week. Ask your surgeon which over-the-counter pain medication they recommend, in case you have any discomfort.Â
Despite any sensitivity, it’s safe to gently wash your hair in the shower. You should sleep on your back and avoid swimming and contact sports, for four weeks post-op, to give the implants time to settle. Doctors recommend skipping earrings for two weeks, to prevent infections, and abstaining from smoking for at least three weeks. (Nicotine reduces blood supply to the ears, which can delay healing and cause the skin covering the Earfold to erode.)
The procedure leaves behind a small scar, which should fade after a few months.
Yes, Earfold is a permanent implant designed to stay under the skin of the ear throughout your lifetime. However, it is removable, if you’re unhappy with the outcome or develop a complication (like skin erosion or an infection).
Earfold implants are considered to be safe, but they also come with some risks and possible complications.
A 2014 study of 403 patients found that the “Earfold prominent ear correction system is associated with relatively few adverse events that require intervention.” However, it also said that 9.7% of those patients required medical attention for complications—including implant visibility (4.2%), skin erosion over the implant (3.7%), and infection (1.7%). This complication rate is similar to that of a standard otoplasty, but the study’s authors say they expect the rate to go down as providers become more familiar with the best Earfold surgical techniques.
A pilot study of 37 patients published in 2016 found a complication rate of 22%, with issues including implant “extrusion, infection, hypertrophic scarring, and Spock-ear formation.” It noted that extrusion was most common in patients who smoked prior to and after their procedure.
Talk with your provider about how to reduce the likelihood of these complications.
Updated June 13, 2023