Ask the Expert

Misfolding or a deformity of the external (or outer) ear is a common finding in newborn children; in fact, approximately 1/3 of newborns have some sort of external ear deformity, ranging from very mild kinks of pinched areas in the outer rim of the ear to severely constricted and misfolded ears (see below).  I like to treat these babies with non-surgical newborn ear correction (also called Earwell treatment) in my facial plastic surgery practice.

“Kinked” ear or a helical rim deformity in a newborn child
Source:  https://www.earwellcenters.com/infant-ear-deformities/helical-rim-ear-deformity-in-newborn-infants/

Newborn ear with lidding (folded over upper part of the ear) and a conchal crus (an extra fold of cartilage just behind the ear canal)
Source:  https://www.avivaplasticsurgery.com/photo-gallery/newborn-ear-correction/ear-correction-case-1181/

Several examples of misfolded or so-called “lop ear” of the newborn child
Source:  https://elementsofmorphology.nih.gov/index.cgi?tid=b03dbc6169755a51

Some children are born with misshapen ears which are pointed, folded over, or excessively “stuck out” from the head.  One or both ears may be affected.  Some children may have a family history of ear deformities.  Most children with ear deformities have normal hearing.

I like to treat these children with non-surgical newborn ear correction, which is a painless and non-invasive reshaping treatment.  As an Ear, Nose, and Throat (ENT) and Facial Plastic Surgery trained physician, I do both surgical and non-surgical ear treatments for reshaping, reconstruction, and repair.  Because babies are born with a high level of mom’s estrogen circulating in their system, their ear cartilage soft and very amenable to molding or shaping.  I like the non-surgical approach to newborn ear correction because it has a high successful treatment rate, does not hurt, and does not require any sedation.  If not corrected during the first few months of life, some children may require corrective ear surgery later in life.

How are Newborn Ear Deformities Treated?
Because very early treatment results in higher success rates, I like to see babies with newborn ear deformities as soon as I can after birth—ideally within the first 2 weeks of life.  The circulating maternal estrogen in the baby’s system affects the softness of the ear cartilage, and I have a roughly 6-8 week of window before this estrogen decreases and the window for treatment closes.  I use soft silicone molds by the Earwell company, or splints I make myself, to reshape the ears and hold them in the desired position for a few weeks; after a few weeks of molding, most patients show good correction of the ear(s) and are done with treatment.  I usually trim a strip of hair around the ear in order to place the splints; beyond this, there are no incisions or need for sedation—in fact, some babies sleep through treatments.  

Non-surgical newborn ear correction allows me to offer non-surgical, painless treatment of many ear deformities, including the too prominent or “stuck out” ear, cup ear, lidding, Stahl’s deformity, and cryptotia (or so-called “hidden ear”).  I place and change the EarWell or custom splints as needed in my clinic, usually treating patients for a few weeks at a time.  These splinting or shaping treatments require minimal home maintenance (they mostly need to be kept dry and occasionally reinforced with a small piece of tape).  Treatment is often covered by insurance.

How Do I Get Started with Treatment?
Because treatment is time-sensitive, I prefer to see babies with a question of misfolded or misshapen ears as soon as I can, preferably in the first 1-2 weeks of life.  My office arranges an in-person consultation or a FaceTime or Zoom consult so that I can take a look at the baby’s ears and discuss my treatment recommendations with the parents.  If I feel the treatment is appropriate, I usually recommend this without delay; in fact, I prefer to start appropriate treatment at the time of the initial consult.  The easiest way to get in the office is to call 678-974-8435 or email.  Furthermore, there’s an Earwell physician locator on the EarWell website.

Where Can I Learn More About Newborn Ear Correction?
I love this treatment, and talk about newborn ear correction on my website and blog, at Aviva Plastic Surgery & Aesthetics. Parents and caregivers can also find my before and after treatment photos on the site.  
Other great resources include the Earwell website and the site of a different treatment system called EarBuddies.

Thank you Dr. Inessa Fishman Facial Plastic Surgeon at Aviva Plastic Surgery & Aesthetics for providing this article.   They can be reached by email or phone (678) 974-8435. They are located at 1100 Johnson Ferry Road NE, Center Point 2, Suite 470 in Atlanta 30342.  Follow on Facebook, Linkedin, Instagram, Pinterest, Twitter, and Yelp.