A Cochlear Mini System 22 Channel cochlear implant extruded through the skin of a young girl. The implant was saved by use of a transposition flap. Extrusion appeared to be due to pressure necrosis from the implant on the overlying tissues. It is believed that this problem can be prevented by angulation of the implant before insertion so that it conforms to the curvature of the skull, so avoiding pressure on the tissues. The method of angulation is described.