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Background: The primary aim of this study was to collect information on the surgical procedures used to implant two cochlear implant variants (non-pin and pin: Concerto and Concerto Pin from Med-El) in adults and children and to assess their medium-term stability. A secondary aim was to assess the safety of these variants, both of which permit a minimally invasive surgical protocol to be used. The pin variant has greater flexibility in positioning and fixing of the implant, with the pins ensuring implant stability; also it requires less or no drilling and no tie-down sutures. Materials and Methods: Non-pin and pin cochlear implant variants (Concerto and Concerto Pin from Med-El) were implanted in adults and children (n = 116) in 5 clinics. The different surgical techniques and methods of implant fixation were documented intraoperatively. Implant stability was subjectively assessed at first fitting and again approximately 3 and 6 months later. Safety was assessed based on the number and severity of adverse events. Results: With all non-pin variants suture fixation was always performed, but with the pin variant this was done for just 43% of adults and 49% of children (in the remainder, no additional fixation was performed). The study demonstrated the stability of both cochlear implant variants in children and adults, with no shifting or rocking observed. There were 33 adverse events reported during the study, 10 of which (9%) were classified as related to the device or procedure. Conclusions: Implant stability and safety can be achieved through various surgical techniques and fixation methods when implanting either the Concerto or Concerto Pin. [ABSTRACT FROM AUTHOR]