Prominent ears, also known as protruding ears, dumbo ears, or bat ears, is when one or both baby ears stick out or are larger than the average ear. This is usually due to not having a fold in the ear which prevents it from folding backwards. It can also be due to an enlarged concha, which is the bowl-shaped part of the middle of the ear.
Studies show that 15-20% of newborns are born with some degree of an ear deformity. An ear deformity is when all parts of the ear are present, but some part is misshapen due to abnormal underlying cartilage. Sometimes just one ear is affected, while other times it can be both ears and the deformities can vary on each side. Newborn ear molding is performed by placing a custom mold on the ear to reshape it to the correct shape. This can be performed in the first month after birth because the ear cartilage is still soft. Ear molding is non-surgical and can be performed in our office.
Before and After Ear Molding
Studies have shown that baby ear cartilage starts to harden about 6-7 weeks after birth. This is sometimes delayed in premature babies whose ear cartilage is softer for longer. The ear cartilage remains soft because of the estrogen hormone that is still circulating in the baby from the mother. The level of estrogen starts to drop around 6 weeks after birth. It is best to start ear molding in the first few weeks after birth before the cartilage starts to harden.
Earwell is a type of ear mold which is applied by a physician and is customized to treat various ear deformities. It can correct most ear deformities and has different ear splints that attach to it to hold the ear in the correct shape. We will sometimes use Earwell in our practice, but it has limitations. For example, even though we prefer starting ear molding in the first few weeks after birth, we have successfully corrected infant ears even when starting at 2 months old. For these larger babies, the Earwell doesn’t always fit. We will use a more customizable mold that is made from a soft silicone polymer. We use the same kind of mold for infant ears which have lidding, where the top of the ear folds down. Lidding ear deformities are not easily corrected using Earwell and we therefore need to make a more custom mold.
When we reshape a baby’s ears, it takes a few weeks to softly and slowly bend the cartilage into the new shape. The ear then has to be held in that shape until the cartilage starts to harden, so that it doesn’t bend back into the abnormal shape. Ear molding can take anywhere from 2-6 weeks depending on the severity of the deformity, the age of the baby, and how soft or hard the cartilage is when molding is started.
Custom ear molding is the most successful way to correct multiple different ear deformities. This is best done by an expert who performs this on a regular basis. Parents will sometimes ask about EarBuddies which can be found online for reshaping baby ears. However, parents often don’t know what the ideal shape of the ear is supposed to be. EarBuddies have to be applied by the parents who also have to monitor for any excessive pressure which can cause ulceration or infection. They are nervous that they are shaping it in the wrong way with EarBuddies.
By contrast, custom molding with Earwell has a very high success rate of over 90% with complete correction when started early enough. Parents don’t have to do anything or worry about misplacement. The procedure is covered by all insurances as an ear deformity is considered a congenital deformity. Ear molding is pain free and doesn’t affect baby hearing or sleeping.
OtoStick is a silicone prosthesis that is taped to the back of the ear and the scalp to hold the ear back in both children and adults. However, it must be used continuously since it doesn’t mold the cartilage - it just tapes it back to the scalp. It is only recommended for children over 3 years old, likely to decrease the incidence of a baby choking on it if it falls off while unobserved.
OtoStick is therefore completely different from custom ear molding with Earwell. Earwell permanently molds infant ears in a period of 2-6 weeks and then can be removed. The key to successful infant ear molding is starting in the first few weeks after birth.
Taping baby’s ears back can also be problematic. Many deformities are more complex than what simple taping can fix. Taping may pin the ears back, but still lead to an abnormal shape or even cause a new deformity. We do not recommend taping as a way to correct baby ear deformities.
When ear molding is performed early, future surgery can be completely avoided. Ear pinning surgery, known as otoplasty, is usually performed when a child is 5-6 years old, before other kids start to mock and make fun of ear deformities. Otoplasty usually requires general anesthesia and has an extended recovery. In addition, otoplasty results can often look overdone and abnormal, and about 20% of otoplasties fail due to a stitch breaking.
Infant ear molding is covered by insurance as it is considered a congenital deformity. However, when a child undergoes an otoplasty at a later age, insurance companies consider it cosmetic at that time and it is therefore not covered by insurance. Otoplasty is a cosmetic out of pocket cost.
If your baby was born with an ear deformity, consider non-surgical ear molding. Time is of the essence. We perform the molding procedure at the first office visit. We will obtain insurance approval before your first visit. Call us for more information - 203-374-0310.