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Schuster. Plast Aesthet Res 2018;5:22 I http://dx.doi.org/10.20517/2347-9264.2018.13 Page 3 of 9

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Figure 1. EarFold introducer

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Figure 2. Single Earfold implant in left ear [appearance before (left) and after (right) insertion]

earrings) should not be used, or only with extreme caution and held away from the incisions. Patients with a
history of recurrent otitis externa were also excluded from surgery or were followed up closely after the pro-
cedure.

RESULTS
The author inserted Earfold™ into the ears of 19 patients between November 2016 and June 2018. Unilateral
implantation was performed in 5 cases; 3 were treated with 1 implant, 2 with 2 implants in each ear. Bilateral
implantation was performed in 14 patients; 2 patients had 2 implants inserted into each ear. The principal
motive for all patients was to avoid standard otoplasty surgery. Many patients had additional reservations
about the need for bulky and visible dressings after standard otoplasty - that might make it obvious that an
otoplasty had been performed.

Fifty-one patients underwent pre-operative assessment with Prefold™: 42 women/girls and 9 men. In 6 pa-
tients, the author advised that they should not undergo the Earfold™ procedure because of a deep conchal
bowl. Moreover, every patient was explicitly advised of the pros and the cons of Earfold™ compared to stan-
[5]
dard surgical otoplasty (especially using the Mustardé technique ). Importantly, Prefold™ positioners were
used to simulate the likely outcome in every case, including those patients with a deep conchal bowl. Inter-
estingly, for some of these patients, even when it was pointed out that they might have to accept an aesthetic
compromise, this was mostly accepted.

Nineteen of the 51 patients who underwent a Prefold™ assessment decided to undergo the Earfold™ proce-