It’s common for newborns’ ears to appear folded, uneven or just slightly different at first. These differences usually don’t affect hearing, but some parents may be concerned about how their baby’s ears look. Ear molding is a simple, nonsurgical treatment option that is only effective within the first few weeks after birth.
Some babies’ ear irregularities will correct on their own. Others require treatment to create a more typical appearance.
“Luckily, this doesn’t necessarily mean surgery,” says James Seaward, M.D., Pediatric Plastic and Craniofacial Surgeon with Children’s Health℠.
Ear molding can’t treat everything, but it can be a painless and effective way to correct the shape of a fully formed but misshapen outer ear, usually with excellent results.
Common ear differences
Pediatric ear deformities range from minor shape differences, such as extra folds or creases, to more severe cases where the outer ear doesn’t develop at all.
Ear molding may help with certain conditions including:
Prominent ears. Ears stick out farther from the side of the head than what is normal for the average person.
Constricted or lop ear. The ear is folded, ear size is different or some normal features are missing.
Stahl’s ear. The ear has an extra crease or fold, giving it a pointed appearance.
Cryptotia. The inner, upper part of the ear is buried under the skin on the side of the head.
If your child is a newborn, they should be evaluated at a plastic surgery clinic prior to two weeks of age to determine if ear molding is an option.
If your child is older than a couple weeks old or their ear shape can’t be corrected with ear molding, plastic surgery may be recommended to improve the appearance of the outer ear.
What is ear molding?
Misshapen cartilage (the strong connective tissue that forms our ears and nose) is a common cause of ear deformations. Ear molding is a simple and pain-free treatment option that uses custom-fitted molds to gently change the shape of the cartilage that forms the outer ear.
How does ear molding work?
When babies are first born, estrogen from their mother stays in their bloodstream for a few weeks, keeping their cartilage soft. Ear molding takes advantage of this small window when the cartilage is pliable enough to be reshaped.
Within a few weeks after birth, estrogen levels drop and the cartilage becomes too firm for molding to be effective. That’s why it’s so important to see a specialist as soon as possible after birth if you’re worried about the appearance of your baby’s ears.
Ear molding: What to expect
During an initial visit, your provider will discuss treatment options and work with you to come up with a plan that is best for your baby.
Ear molding involves a short in-clinic appointment with an experienced provider who uses a special type of clay to create custom molds for your baby’s ears that are secured in place using surgical tape. The whole process is painless and usually only takes about 15 minutes per ear.
You can expect to keep the molds on for three weeks. Then babies are typically fitted for a second set of molds that stay on another three weeks, for a total of six weeks of treatment. Newborns are adaptable and don’t seem to be bothered by the molds.
“There’s overall very little downside to trying this treatment so we encourage anyone who is concerned about their baby’s ear shape to come in for a consultation,” says Elizabeth Wetz, PA-C, a physician assistant who specializes in ear molding at Children’s Health. “Our clinic prioritizes these types of appointments to ensure families can get in to see us as soon as possible after birth.”
Benefits of ear molding for babies
Minor ear shape differences may not affect a child’s hearing, but they can impact a child’s life in other ways. It could be difficult to wear helmets or headphones, or they may experience lowered self-esteem or social issues as a result.
Beyond the potential for some minor skin irritation, ear molding is not harmful and carries minimal risk. Most importantly, this treatment can eliminate the need for reconstructive ear surgery – which is costly, invasive and involves a long recovery – later in childhood or adolescence.
Surgical ear reconstruction for kids
Ear reconstruction surgery may be necessary to create more typical-looking ears for children who are older than two weeks old or for whom ear molding isn’t an option.
Unless hearing is affected, surgical correction usually isn’t considered until a child is around six years old, when the ear has grown closer to an adult size. It is still a good idea to meet with your provider as early as possible to be sure the correct plan is in place.
Surgical intervention might be necessary for conditions including:
Accessory tragus or branchial cleft remnants. Extra skin and cartilage is left on or around the ear.
Microtia or anotia. A malformation of the outer ear, making it so small or abnormally shaped that it often does not look like an ear. In the case of anotia, the outer ear is not present at all.
Aural atresia. The ear canal is absent.
Some of these malformations may involve the ear canal, affecting hearing and requiring a more complex approach. At Children’s Health, reconstructive plastic surgeons work with Ears, Nose and Throat (ENT) specialists to create a treatment plan that’s right for your child.
In more severe cases of microtia or anotia where a surgical intervention cannot guarantee a typical-looking ear, a prosthetic ear can be an alternative.
Learn more
The Fogelson Plastic Surgery and Craniofacial Center at Children’s Health provides diagnosis and treatment for children of any age with any reconstructive need. Our multi-disciplinary team of highly trained and experienced surgeons and providers work together to ensure the best results. Learn more about our programs and services.
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