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EArfold Implant

EArfold Implant

Postby donns1979 » Thu Jul 18, 2013 4:02 am

I know this is a very new procedure, currently undergoing clinical trials but available to private patients at Royal Free Hospital in London. Does anyone know anybody who was part of the trial or has had the procedure. Sounds too good to be true!?

I have made enquiries and the earliest availablity they have for a consultation is November this year. Apparently huge interest been shown in the procedure.
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Joined: Wed Jul 17, 2013 6:11 am

Re: EArfold Implant

Postby donns1979 » Tue Apr 15, 2014 8:22 am

Just reposting this to see if anyone has had a consultation about this procedure.

I did have one scheduled for last November but had to cancel due to work commitments. I now have an appointment in June with Dr Kang.

I note the procedure is now being offered in a number of other clinics in the uk and abroad.

Has anyone been for a consultation, or know anyone one who has been or even had it done?

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Joined: Wed Jul 17, 2013 6:11 am

Re: EArfold Implant

Postby DCJeff » Thu May 01, 2014 7:11 pm

I would also be interested in anyone's personal experience or knowledge of this. It sounds like a really attractive solution.
For what it's worth, here's a brief discussion on "Yahoo Answers" that includes one person who was involved with the initial trials and had a good outcome:
https://answers.yahoo.com/question/inde ... 715AAraihX
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Joined: Mon Mar 11, 2013 6:26 pm

Re: EArfold Implant

Postby donns1979 » Tue Jul 01, 2014 8:05 am


Just an update for anyone who maybe looking into possibility of treatment with Earfold.

Had a consultation yesterday. In essence the surgeon has the clips which are used in the procedure and during the consultation these are attached with tape to the ear and moved around to achieve the best possible result.

I am only concerned re the upper poles of my ears so did not have any tried on the bowl area so cant comment on their effectiveness on that portion of the ear. The clips once in place do make a dramatic difference to the top part of the ear.

In my case I am looking for a subtle set back of the upper poles. One ear looked good with one clip in place. The other not quite so good (the very top of the ear was still slightly prominent) and with a second clip in place was slightly over corrected.The surgeons opinion was the expected results should I proceed to surgery were acceptable but traditional method otoplasty would be preferable for the result I hope to achieve, as to some extent the earfold had too much of a correcting effect on my ears.

I am not ruling this out and it seems a good option for the right type of case. It was certainly worth going for the consultation so I can consider all options and make an informed decision.

The surgeon took numerous photos with the clips in place and will be emailing me with them so I can study them and make a final decision if I go ahead with either option or leave things as they are.

Hope this info. may be of some assistance to anyone looking into the Earfold.
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Joined: Wed Jul 17, 2013 6:11 am

Re: EArfold Implant

Postby grecian » Thu Jul 24, 2014 1:10 pm

I have had the ear fold procedure. From the outside it does look wonderful and it is an ok method but not wonderful. I am not blown by the results and it took alot longer for the healing process then first thought.
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Joined: Mon May 19, 2014 2:09 pm

Re: EArfold Implant

Postby Tom24 » Sun Jul 27, 2014 11:40 am

I had mine done 15 days ago ,
Like the other guy has said ,it's not perfect but it is an improvement of the ear shape.It still sticks out but not as much .I paid 1500 £ which is a lot,
15 days after the procedure ,only a bit of the stiches are left.
In short i think this is a procedure for someone that want to fold ears a bit ,i would have rather gone for the proper procedure which cost 2200 pounds for both ears .Any questions please dont hesitate to ask
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Joined: Thu Jul 10, 2014 11:13 pm

Re: EArfold Implant

Postby donns1979 » Mon Jul 28, 2014 4:01 am

Hi Grecian/Tom24

Thanks for the above posts and sharing your experiences of the procedure.
Can I ask if you had one or both ears treated and how many clips in total.?
Are the implants visible under the skin?
I have been thinking about the method since my consultation. What appeals is the less invasive approach, and suggested shorter healing time. However it seems from your posts the healing time isn't as quick as is suggested.
Any additional info. advice you could provide would be much appreciated.
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Joined: Wed Jul 17, 2013 6:11 am

Re: EArfold Implant

Postby grecian » Mon Jul 28, 2014 10:12 am

ok here goes, i had both ears done a fews months back now.
This procedure is good if you need the top part of ear pinned back slightly. Both of my ears stuck out top and bottom and after procedure they are only slightly better, in my opinion this would suit people who only want there ears back only a few millimetres.
You can not see the actual implant but you will get slight bruising around that area.
Ask your self , if this procedure is so good why are the nhs still using the old fashioned otoplasty method ? After all this is meant to be low risk,quick ,easy .
Overall i wish i had of just gone for the normal cut and stitch method.
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Joined: Mon May 19, 2014 2:09 pm

Re: EArfold Implant

Postby Merck456 » Mon Aug 04, 2014 12:41 pm

There is another minimally invasive ear pinning method, the so-called stitch method, that is even less invasive than the Earfold surgery. Compared to the Earfold surgery, the stitch method has the following advantages:
1. Incisions on the front of the ear are not necessary by the stitch method; there are only stitch points, in contrast to incisions, that always heal without scars.
2. There is the question whether the metal implant of the EarFold method is bent when lying on the ear, thus causing the ear to return to its original position. With the stitch method, the position of the ears is not changed if one lies or sleeps on them.
3. With the Earfold surgery, a large cavum conchae must be reduced by the excision of cartilage, i.e. it must be combined with a traditional method. This is not necessary with the stitch method.
4. With the EarFold Surgery and in patients with thin skin, the metal colour can be visible through the skin even if the implant itself is not prominent.
5. If the metal implant has to be removed due to intolerance, you must count on the ear returning to its original protruding position.
6. The occasionally observed sensitivity problems with the EarFold method do not occur with the stitch method.
7. With the stitch method, there are meanwhile long-term results over a time period of 18 years based on more than 8000 operated ears. With the Earfold surgery, there is only a limited experience of less than 100 ears over 2 to 3 years.

Priv.Doz.Dr.med.W.Merck, Konstanz, Germany
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Joined: Wed Mar 02, 2011 5:58 pm

Re: EArfold Implant

Postby grecian » Mon Aug 04, 2014 1:15 pm

Merck456, ok your method sounds good and i do agree with some of your above points regarding the implant.
What are the chances the public ( especially the people that use this site) can see some evidence by the way of pictures your method provides a result ? recent ones would be good.
My bet is we may be waiting some time !
Sorry if that comes across rude.
regards Grecian
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Joined: Mon May 19, 2014 2:09 pm

Re: EArfold Implant

Postby Merck456 » Sat Aug 09, 2014 1:27 am

Hello Grecian,
If you would like to see some before and after photos next to one another, please look at the photos under my profile on RealSelf.com: http://www.realself.com/find/Germany/Pl ... rck#photos
You will get a description of them when you click on each set of photos.

I have many more examples at my practice in Constance (Germany) which you are welcome to come and look at anytime, but unfortunately I’m not permitted to send them to anyone or post them on any website due to patient privacy. I hope you understand.

Priv.Doz.Dr.med.W.Merck, Konstanz, Germany
Posts: 29
Joined: Wed Mar 02, 2011 5:58 pm

Re: EArfold Implant

Postby arjay171 » Sat Jan 10, 2015 10:17 am

I have had the Merck stitch procedure done. I have several comments I would like to pass on to you. If you leave an e-mail address on here I will send you my comments and some photos that should help you make your mind up.
Robin Green
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Joined: Thu Sep 26, 2013 8:46 am

Re: EArfold Implant

Postby Merck456 » Sat Jun 02, 2018 5:12 pm

The Earfold Method has numerous disadvantages compared to Dr Merck Stitch Method:

1. The EarFold Method is not minimally invasive like the Merck Stitch Method as the skin of the ear is raised from the cartilage approximately 1 cm in width and 2.5 cm in length to create a pocket for the Earfold implant (see video http://links.lww.com/PRSGO/A639). This is done several times depending on the number of implants to be inserted. There is thus the risk of developing haematomas and infection. With the stitch method, the skin of the ear is not raised from the cartilage anywhere. The only wounds are the stitch points of a tiny needle on both sides of the ear, and two to three stab incisions of merely 2-3 mm in length on the back of the ear.
2. Incisions of up to 1 cm in length are made on the front side of the ear to insert the metal implants. Such incisions are not made with the Merck Stitch Method.
3. The plastic surgeon Dr. Norbert Kang from London reports that after operating on slightly more than 450 patients with the Earfold Method, there is only a permanent effect with Earfold if it is combined with a cartilage-weakening procedure involving scoring or needle perforations through the cartilage several times. This means reverting to the invasive traditional methods and should be banned from ear surgery.
4. These incisions on the front of the ear can leave behind visible scars, particularly when there is a predisposition to form hypertrophic scars, or even keloids (excessive and conspicuous scar development which is difficult to remove).
5. The metal implants can shift position when one lies on the ears in the first weeks after the operation and affect the pinning result. With the Merck Stitch Method, the position of the ears does not change if one lies on them as the threads can’t change their position.
6. The Earfold Method can’t correct all causes of a protruding ear. If there is a large cavum conchae (big bowl-shaped cavity before the ear canal entrance), which often leads to a protruding ear in the middle third, the ear can’t be adequately pinned in this area with the metal implants. In comparison, this is easily possible with the Merck Stitch Method by a so-called medialisation of the antihelix, namely with threads only, without incisions and without removal of any cartilage.
7. As the skin on the front of the ear is significantly thinner than on the back of the ear and the implants are positioned on the front of the ear, the implants can be visible through the thin skin. If the implant shifts or turns, its edges and corners will become visible. The implants must therefore be removed. We can pin the ears of such patients again with our Stitch Method only after the removal of the Earfold implants.
8. The Earfold implants have small tines with which they grip the cartilage. The tines damage the surface of the cartilage if an implant has to be removed after a long period.
9. Permanent sensitivity disturbances of the ears can occur with the Earfold Method. These don’t occur with the Stitch Method.
10. There is still no publication on the long-term results of the Earfold Method as it has only been in use for a short time. With the Merck Stitch Method, there are, in the meantime, long-term results of 20 years on more than 11.000 successfully operated ears and the results have been published. There is only a very limited period of experience to date with the Earfold Method..
11. If there is a complication in the form of an infection or rejection of the implant after the utilization of the Earfold Method, the correction possibilities are difficult and not very promising. In such a case, the metal implant must be removed until healing is complete. The same prepared pocket, in which the metal implant lies, can no longer be used because of adhesions and scarring of the thin skin on the front of the ear. The skin would otherwise tear at this place. New pockets must be created in another part of the skin for a renewed correction at a later date, or one must resort to another method.
12. It is not, as occasionally claimed, less painful than the Stitch Method
13. When the sun shines through the ear from behind, one can detect the metal part as a dark shadow. The threads of the Stitch Method can’t be seen like this.
14. To avoid pressure on the ears, it is recommended to sleep on the back for approximately 4 weeks with the Earfold Method. With the Stitch Method, the patient is allowed to sleep on his ears right after the operation.
15. With the Earfold Method, the patient should not swim for roughly 4 weeks if possible, nor play any contact sports, so that the implants can settle. With the Stitch Method, one can already swim and play contact sports 10 days after the operation. One is only advised against professional wrestling.
16. With the Earfold Method, one is advised against wearing earrings for about 2 weeks to decrease the risk of infection. With the Stitch Method, earrings may be worn again immediately at the end of the operation.
17. With the Earfold Method, one is advised not to smoke for about 3 months if possible as nicotine decreases the flow of blood to the ear, which greatly increases the risk of complications. This also applies to e-cigarettes, nicotine plasters or chewing gum. There are absolutely no such restrictions with the Stitch Method.
18. The Earfold Method is offered from the age of 7 years. The Stitch Method can be used earlier, namely from 5 years of age and thus in time for the first day of school, which is important to avoid teasing.
19. The patient only learns during the examination of his ears whether the Earfold Method is suitable for him. In comparison, the Stitch Method is suitable for all protruding ears and thus no patient is sent home again with the finding that the Stitch Method is not suitable for him.
20. The surgeons offering the Earfold Method advertise that it is a method by which one is shown the new position of the ears before the start of the operation. However, the patient is unlucky if this position is not to his taste because the implant has only one standard, pre-set curve. This doesn’t always lead to the ear-to-head distance desired by the patient. With the Stitch Method, the patient demonstrates the desired distance of his ears to his head in a mirror and he really receives this distance.
21. With the Earfold Method, it is mentioned that irregularities can occur in the ear. It has also happened that the upper part of the antihelix is not naturally curved forward but is rather too vertical, thereby creating an upper pointy, so-called Spock Ear. (see the publication by Kang and Kersten from the year 2016 in the Aesthetic Surgery Journal). Irregularities, including the Spock Ear, do not occur with the Stitch Method.
22. If a patient is not satisfied with the result of the Earfold Method, it is pointed out that the only remaining alternative is the traditional ear pinning operation, which sometimes requires a general anaesthestic. This assertion is not correct as there is no mention of the Stitch Method whereby ears can be pinned even less invasively and under local anaesthetic from the age of 12.
23. It is pointed out that when the Earfold implants have been in the ears for 2 to 3 years, the ears will stay in their new position when the implants are removed. That is false. The implants must remain in the ear for a minimum of 10 years for the ear cartilage to remain reshaped.
24. In the publication mentioned below, an examination of 403 operated patients revealed that skin necrosis (erosion of the skin) over the implants occurred in 3 to 4 percent of the cases with the Earfold Method. This is not possible with the Stitch Method and has therefore never occurred.
25. If an implant has to be removed, it is considerably more complex and difficult than if a thread has to be removed with the Stitch Method.
26. There are now many surgeons performing the Earfold Method, meaning that there is only a small number of operated patients per surgeon. The surgeons can acquire only a little experience and thus do not know the possible complications of the method from their own experience. In a publication by Kang et al from 2018 in the Plastic and Reconstructive Surgery Journal, in which 403 operated patients with the Earfold Method were assessed over a period of 30 to 48 months post-operatively, 9.7% of the patients required a renewed intervention due to adverse effects, including skin erosion over the implants (3.7%), and infection (1.7%). It must be taken into consideration that the observation period was short and further complications that could have occurred later were not documented. More than 11,000 protruding ears have been successfully pinned in the last 18 years with the Stitch Method, thereby guaranteeing adequate experience. Only a few complications were observed that were not dangerous and were treatable. These are mentioned on our website.

Dr. W. Merck, Marktstätte 11, 78462 Konstanz, Germany
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