Comparison of Different Surgical Techniques for Osia® System Implantation—Experience from Two European Clinical Centers

<b>Background/Objectives</b>: This study aimed to compare two surgical techniques for Osia^® system implantation performed at two European clinical centers: Poznań (Poland) and Freiburg (Germany). <b>Methods</b>: The study included 83 patients who underwent Osia^® OSI200 and OSI300 implantation (89 implants). The analysis focused on surgical technique, postoperative healing, and long-term skin integrity and aesthetic outcomes. <b>Results</b>: The centers differed in their surgical approaches, particularly regarding skin incision design and bone preparation. Most patients experienced no complications. Implant explantation was required in two cases, and one patient with recurrent seroma underwent revision surgery. Both centers achieved excellent postoperative skin integrity, with minimal scar visibility in most patients. Patients treated in Freiburg showed significantly better outcomes in terms of retroauricular bump visibility or palpability (<i>p</i> < 0.05) and postoperative pain (<i>p</i> < 0.05). Conversely, patients operated on in Poznań reported numbness less frequently (<i>p</i> < 0.05). <b>Conclusions</b>: Osia^® system implantation is a safe and well-tolerated procedure, with postoperative complications occurring in only a small proportion of cases. The Freiburg technique appears to reduce visibility and palpability of retroauricular bump and postoperative pain, but may slightly increase the risk of numbness and, in some cases, lead to a more visible scar compared to the Poznań approach. Optimal outcomes may be achieved by combining elements of both surgical techniques.