A Cure for Badly Protruding/Prominent Ears

Robert Traynor
January 28, 2014

The protrusion of ears can be a significant problem.  We can all relate to the teasing that results from being  different, espepe1cially as teenagers.  Protruding ears  affect about 5% of the general population worldwide and  is the most frequent deformity of the head and neck area.  This week’s Hearing International will review the problem and present a new surgical implant procedure for its treatment. 

While not yet cleared by the Food and Drug Administration (FDA)  for use in the US, the procedure has been approved in the UK, South Africa, Canada, Mexico, Australia, and countries across Europe and Asia.  Basically, it takes a relatively painful Otoplasty surgical procedure performed under general anesthesia and turns it into an incision-less 20-minute procedure. 


The Problem: Protruding Ears

Prominent/protruding ears are found in both genders equally and are not associated with other abnormalities or syndromes.  However, they can be esthetically displeasing, a source of psychological distress, and, in some instances, dysfunctional. Most often the patient is a child whose parents seek a plastic surgery evaluation due to their child’s distress over ridicule by other children. While most patients are children,  it is not just a problem of schoolyard teasing. Adults with an uncorrected prominent ear deformity usually seek treatment due to life long struggle with insecurities about their ears. 


What causes Prominent or Protruding ears?


For the most part, genetics play a large role. People who have protruding or prominent ears often share this with others in the family. While the specific etiology remains unknown,  approximately 8% of patients with prominent/protruding ears have a family history of the abnormality.   The “cause” of this is generally a defect in the Auricular cartilage of the ear.  It is very rare that pe12a person’s ears protrude because of an injury or accident.  The most common causes of prominent/protruding ears are an underdeveloped, effaced, or absent antihelical fold or an overdeveloped and/or excessively deep conchal bowl.  Additionally, a prominent mastoid process may also contribute to the protrusion. The condition may be unilateral or bilateral. There may be minor defects in the lower portion of the auricle that may also be a factor in the overall defect, although these minor defects are often overlooked. 

The external ear develops more rapidly than other components of the craniofacial anatomy. Different portions of the ear grow at different rates. By age three, ear width will reach approximately 90 percent of adult dimensions. By the end of the first year of life, about 75 percent of the ear length will occur. Elastic properties of ear cartilage are normally age dependent. Before age 6 years, cartilage is malleable, and suture repositioning is maintained with a low incidence of recurrence.  Adolescent and adult populations have stiffer, less pliable cartilage.


Traditional Treatment Techniques for Protruding Ears

For babies under 6 months of age with their pliable cartilage, non-surgical treatment can be effective.   Taping or splinting of the pe6auricle has been successful.  Some physicians have also used molding devices made of plastic ora wire wrapped with micro-foam tape, contoured to fit the ear, conforming the deformed areas into a normal shape.  The time needed to correct the deformity varies from a few days to several months.

pe7For older children and adults, the specific surgical technique is determined by the anatomic deformity and performed under general anesthesia. Procedures performed include a postaricular incision and the excision of excess skin.  Remarkable results are usually achieved only through invasive ear surgery – known as conventional Otoplasty – in which the cartilage is cut. This procedure lasts 90 minutes and is conducted under general anesthetic. 

In this procedure, surgeons will work to create an anti-helical fold, conchal reduction or setback, modification of the lobule and its fatty fibrous tissue, as well as an array of suture types to modify the look of the Auricle and its prominence.  Click on the Video “Otoplasty” (left) to review the current procedure.

Now there is a pioneering new procedure that can put an end to the torment, using an implant inserted under local anesthetic that corrects the ears’ prominence in just 15-20 minutes. 


Whape8t is the Earfold Procedure?

This procedure, performed in less than 20 minutes under local anesthesia, offers immediate correction and rapid recovery.  The earfold™ implant 


produces consistent outcomes with less discomfort and fewer side effects than traditional otoplasty surgery. The implant reshapes the patient’s Auricle with a simple procedure that places it under the involved ear through a small incision. One of the most consistent methods for measuring the degree of prominence is the helical – mastoid (H-M) distance (Right).  Typically, the H-M distance is 18-20 mm.  As the H-M distance increases, the ear is perceived to be increasingly

pe9.prominent or protruded.  The H-M distance is measured before treatment so that a comparison can be made with the H-M distance after treatment with earFold™. The incision is then closed. While in place, earFold™ re-molds the cartilage of the ear allowing it to maintain its new shape and, due to its  flexibility, allows for natural movement of the Auricle so that when moved it will always spring back to its corrected position.  

The earfold™ implant is made of a short strip of nitinol metal alloy. Nitinol alloy is made of two metals, titanium and nickel, that are widely used in medical fields. The implant is made from the same material used for coronary artery stents (for patients with heart disease or vascular disease due to a blockage of their arteries) and also for unbreakable spectacles.

The implant is simply a curved, wafer-thin strip of metal (about the thickness of a human hair), which is plated with 24-carat gold that reduces the visibility of the implant under the skin.   The earFold™ implant has undergone extensive laboratory and human clinical testing over several years but is not yet approved for use in the United States.



Before and After

Earfold – Before and After

One of the first patients to have benefited from the procedure is Jeremy Wood, 53, a senior valuer for the auction house Bonhams in York, England.  “I inherited my sticking-out ears from my father and was called ‘bat ears’ by the boys at school,” he recalls. “I have felt self-conscious about them all my adult life. Strangely I’ve minded more as I’ve got older, maybe because you notice it more as you get balder. But I never considered surgery until I heard about the implant. My daughter has the same ears as me, and had traditional otoplasty surgery on the NHS at the age of ten. It was quite traumatic and she still suffers from increased sensitivity around her ears, four years on. But this sounded incredibly simple so it appealed.”  Although pain and swelling can last up to two weeks, no follow-up treatment is required.   Jeremy says: “It was a little sore for a few days afterwards but that was it. I was astonished.”

Before and After

Earfold – Before and After






  1. Hi I’m in High School. I am beyond desperate to fix my portruding ears. This has and is causing great distress in my life. HOW MUCH DOES THE EARFOLD PROCEDURE COST in South African Rands AND IS it avalaible in South Africa?? Please. reply I am. extremely desperate!!!

    1. I’m in south africa and looking for a desperate fix the fees at hospitals are 35k I hope earfold is cheaper

  2. Will the earFold treatment ever be approved in the USA? This would make such a difference in my life!

  3. When will this be available in Canada, what provinces and what is the approximate cost? Many thanks.

  4. Does anyone know if this is available in Australia? If so, where? If not, when? It seems so preferable to the standard otoplasty procedure.

  5. I am in the Philippines. Having a potruding ear, I almost had a fight since child and even at present, due to this curse of nature in me.. Now, may I ask your help?..Are there any hospitals or private clinics conducting earfold treatment in our country or other Asian neighboring countries?. For my whole life, I have been searching for specialist who could fix my ear. I want a change and I’ll pay just to end up picking fight on somebody teasing and making always a bad day for me.. Thank you..

  6. Dear Theodor,

    Thank you for getting in touch with us.

    Currently the procedure is only available in the UK and Croatia. We have plans to bring earFold to the US/Canada/Asia/Australia however this is unlikely to happen for a couple of years. If this is too long for you to wait however I suggest you travel to Croatia. For more information the website can be found here: http://www.glumicic.com/en/. The price of having the procedure is Croatia is less than in England, the surgeon’s fees are only 600 Euros, then all you have to pay on top is the price of the implants which are below.

    The first step is an assessment of your ears by one of our plastic surgeons based at one of our hospitals/clinics. This assessment is important to determine whether your ears are suitable for treatment with the earFold™ implant. If your ears are not suitable for treatment with earFold™ implants, the surgeon will be able to advise you on alternative treatments for your prominent ears. You should also understand that, in addition to the insertion of earFold™, it is sometimes necessary to perform additional procedures to achieve your desired goals. The surgeon will be able to advise you accordingly.

    Patients may need either one or two implants in each ear to achieve the desired correction. Additional corrective procedures will need to be quoted individually. Your initial commitment is only the initial consultation fee after which you will have time to consider your options.

    I hope this information helps you to make a decision on whether or not to proceed with the treatment. If you wish to go ahead then please contcact the hospital directly using the details below:

    Royal Free Hospital: Helen Mann
    Email: [email protected]
    Phone: 0207 794 0500 ext. 33671
    Post: Addressed to Helen Man in the PPU at the Royal Free Hospital

    152 Harley Street Ltd: Laura Hattersley
    Email: [email protected]
    Phone: 0207 042 1800

    Spire Harpenden: Carolyn Butterfield
    Email: [email protected]
    Phone: 01582 714 474
    Post: Addressed to Carolyn Butterfield, Spire Harpenden Hospital, Ambrose Lane, Harpenden, Herts AL5 48P

    Selston Clinic:
    Email: [email protected]
    Phone: 01623 555 244
    Web: http://www.lipoplastyinternational.com/contact/contactform.html

    The Private Health Practice:
    Email: [email protected]
    Phone: 01722 342 630
    Post: Millstream House, Avon Approach, Salisbury, Wiltshire, SP1 3SL

    Best wishes,

    The team at Northwood Medical Innovation Ltd
    Visit our website: http://www.earfold.com/
    and watch: http://www.youtube.com/watch?v=x2x3GF1xgF8

  7. When exactly is being made available in Australia? It’s in great proximity to other countries that would also benefit. I also know a few ppl that be very interested locally

  8. Hi
    I am unable to find any SA details under lipoplastyinternational.com? Pleas, if possible, provide me with a name and contact details.

  9. We are offering an EARFOLD initial assessment clinic in Pretoria on Tuesday 1st JULY 2014.
    Please email [email protected]
    or whatsapp/txt to +44 7778577912 or +27 825516359 for availability.
    See Lipoplastyinternational.com and earfold.com for further information on this beautiful new procedure for the management of prominent ear(s) ”Earfold”
    No down time, no dressings, totally reversible, Local anaesthetic, quick healing and predictable outcome.

  10. Please bring this to Australia! There are already 2 other comments on here asking for it to be in Australia.
    I’ve had otoplasty done before and it was extremely painful and the results didn’t even end up permanent. I would choose this method over the old otoplasty any day. Please advise when we might expect it in Australia?

  11. would love this to come to australia, is there anything that can be done to get this in australia quicker than a couple of years??? would love to get this done

  12. Please bring this to the u.s.a it’ll help my life be easier.. thank u

  13. Do you think earfold will be free on the NHS soon as an alternative method to traditional otoplasty ?

  14. My grandson is 6 months old, is beautiful, but has protruding ears. Is the surgery performed in the U.S.?

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