Although Dr. Lewin used the traditional 2-piece Medpor implant for over a decade and was satisfied with the results, she was frustrated with the implant’s limitations:
The rim is too uniform
and can fracture
It’s very difficult to
create a deep, realistic
The implant tragus
is a poor design and
therefore not usable
The bowl is too small
and the wrong shape
The base is unstable
and can slide
downward over time
How does the 3D Lewin Ear correct these shortcomings?
3D LEWIN EAR implants are the most realistic implants available
This patient is shown ONLY 3 ½ months after one operation. The definition, skin color and scars will continue to improve for another 6 to 9 months. However, even this early after surgery, the realism of the ear is apparent.
Dr. Lewin strives to match not just the front and side views of the ear, but the deep space behind the ear as well. This is very important if one wants to wear their hair short or in a ponytail, when the back of the ear is visible.
Neither the rib cartilage framework nor the Medpor implant can replicate the 3-dimensionality and intricate contours of the ear as accurately.
The Medpor rim looks “manufactured” because the curve of the rim is too uniform
3D LEWIN EAR implants virtually eliminate the risk of fracture
The traditional 2-piece porous polyethylene implants (Medpor/Su-Por) have inherently weak areas where the helical rim is melted to the base. This translates to a lifetime risk of fracture with this type of implant.
This is significant for two reasons:
- The risk of fracture increases over time due to daily “wear and tear” on the implant
- If a fracture occurs, SURGERY IS REQUIRED to replace the implant
So even though the risk may be relatively rare (about 3%), for the patient whose implant does fracture, it has a significant consequence.
Dr. Lewin’s years of training in architecture and design enabled her to understand the fundamental flaw in the 2-piece implant design and then develop a solution to counteract that defect.
Lewin Ear Implants are created by Su-Por from a single piece of porous polyethylene. Since there are no joints welded together, there are no inherent weak spots in the framework. Even though these implants are quite thin, the way that the 1-piece design is manufactured gives strength to the entire structure, essentially eliminating the risk of fracture.
No one can predict the future, but of the more than 150 Lewin Ear Implants Dr. Lewin has completed to date, NONE have fractured.
3D LEWIN EAR implants create a
Creating a deep “simulated canal” is a challenge in PIER surgery. The 2-piece Medpor/Su-Por implant often leads to a reconstructed “canal” that is too shallow, so the ear seems less realistic. The mirror image Lewin Ear Implant makes the “canal” the same dimensions as the natural ear, improving the realism of the ear.
3D LEWIN EAR implants create a symmetric tragus and conchal bowl
LEWIN EAR implants minimize slipping
DESKTOP VERSION FOR THIS SECTION (next 3 pictures), MOBILE BELOW
MOBILE VERSION FOR THIS SECTION
The implant has fallen down
over the canal due to the
unstable base. Surgery is
needed to raise the implant.
2-piece Medpor/Su-Por implants have a known risk of moving down over time. This can adversely affect symmetry if the implant sits lower than the opposite ear.
More importantly, for patients with a canal reconstruction (atresia repair), if the implant slides downward and partially blocks the canal, surgery will be needed to avoid infections and keep the canal healthy.
Dr. Lewin believes one reason implants slide down is because the base of the 2-piece Medpor/Su-Por implant is not stable due to its very small “footprint.” Using a “sling” or “cuff” of a fascia and sutures may help minimize the implant dropping, but they don’t address the cause of the problem since the 2-piece implant design doesn’t reliably hold its position.
Dr. Lewin designed her new implant base to have a “footprint” 3 times larger than the old-style 2-piece implants. This configuration has better traction to the tissue, allowing the canal to stay centered within the implant bowl.
When evaluating results, families should look closely at the position of the surgical canal relative to the bowl of the implant.