Otoplasty (Ear Reshaping)

Ear reshaping surgery, also known as otoplasty, can improve the shape, size, position or proportion of the ear.

A difference in the ear structure that is present at birth or that becomes apparent with development can be corrected with otoplasty.

Otoplasty can also treat misshapen ears caused by injury.

Otoplasty creates a more natural shape while bringing balance and proportion to the ears and face.

Correction of even minor deformities can have profound benefits to appearance and self-esteem.

If protruding or disfigured ears bother you or your child, you may consider plastic surgery.

Prominent Ears

Prominent ears are the most common reason for which patients have Otoplasty, or Ear Reshaping.

Prominent ears, also known as protruding ears, occur when the ears stick out too far.

It is common for one ear to stick out farther than the other ear.

Surgery in children is often sought due to teasing at school.

Children are typically not bothered by their protruding ears until other people notice and comment on them.

Adults often seek ear pinning when it has bothered them for some time.

Treatment Goals

The goal in correcting prominent ears is to achieve a normal appearing ear.

The idea is to achieve an ear that maintains a smooth natural curvature, avoiding sharp angles, and a balance between the top, middle, and bottom third of the ear.

The ear is to be set back to a natural extent, maintaining a space between the ear and the side of the head.

Any scars are hidden.

Another goal is to correct the protruding ears before the time of school/socialization to avoid teasing.

Surgical Treatment (Ear Pinning)

Pinback Otoplasty, or ear pinning, is performed using an incision hidden behind the ear.

There are 3 levels that must be evaluated and corrected as needed.

Dr. Costa evaluates the upper third, middle third, and lower third, or lobule of the ear.

Measurements are taken and a surgical plan devised.

Areas of cartilage are folded and sutures are used to define the shape and position.

The antithetical fold is typically deficient and is created with sutures.

Cartilage may be removed in order to set the ear back.

Sutures on the back of the middle cartilage portion of the ear, the concha, are also used to set the ear back.

Timing of Otoplasty

Otoplasty can be performed before the ears finish growing; otoplasty does not adversely affect the growth of the ear.

Aftercare for Otoplasty

There will be a headwrap over your or your child’s ears for a few days.

At your first postoperative visit, Dr. Costa removes the dressing.

A simple headband is used to protect the newly set back ears for about one month.

Cost of Otoplasty

In some cases, otoplasty is covered by medical insurance.

Other times, it is an out of pocket expense.

Non-Surgical Treatment (Neonatal Ear Molding)

Why might I want my baby to have Ear Molding?

If your baby’s ears have a deformity, such as sticking out too much, you may want to consider Neonatal Ear Molding.

Neonatal ear molding allows ear deformities to be addressed painlessly, early in life, and before school related teasing.

It prevents the need for surgery later in life and the risk of your child being teased due to their ear appearance with a potential negative effect on their self-esteem.

What is Neonatal Ear Molding?

Neonatal Ear Molding is a non-surgical approach to reshaping ears in the early period after birth from a misshapen to a normal shape.

This approach takes advantage of the fact that newborn cartilage is soft and is able to be reshaped.

It is a non-surgical, non-invasive, painless office procedure.

What are the treatment goals for Neonatal Ear Molding?

The primary goal is to correct the ear deformity and to produce a normal appearing ear.

This would avoid the need for surgery in childhood, adolescence, or adulthood.

How does Ear Molding work?

This non-surgical procedure takes advantage of the high levels of maternal estrogens that are present in your infant and keep the cartilage soft and moldable.

Custom made ear molding materials are used to gently change the shape of your baby’s ear over time.

Dr. Costa applies medical tape to affix the custom mold to your infant’s affected ear or ears.

Your infant would be seen every 1-2 weeks, at which time the custom mold is changed to a new mold.

Extra tape is provided to help reinforce the existing tape as needed until the next molding session.

Your infant is able to have a bath, and its simplest if the ear area can be kept dry while the mold is in place.

The molding procedure treats the outer ear. 

Any abnormalities of the inner ear would be treated by an Ear Nose and Throat (ENT) specialist.

What conditions does Neonatal Ear Molding Treat?

Ear molding can be used to treat problems such as prominent or protruding ears, cryptotia, Stahl’s ear, constricted ears, cup ears, lop ears, and problems of the helical rim (lidding, absent helical rim, irregular helical rim, compressed helical rim).

Ear molding best treats deformities, where all the normal parts of the ear are present but misshapen.

If there are parts of the ear that are missing, such as what occurs with microtia, the best treatment is likely to be ear reconstruction surgery later in life.

Ear lidding: Ear lidding is a common reason for which parents bring their babies into our office.

Ear lidding appears as if the outside rim of the ear (helical rim) is folding over on itself.

This can be corrected within the first 7-10 days of life if the folding is mild.

After this time, and particularly if the folding is more severe, it will not self-correct. In these cases, molding can be used to gently reshape the ear rim.

Timing for Ear Molding: Starting Early is Key!

Treatment is begun ideally as soon as possible and preferably no later than 1 to 2 weeks of age.

The number of molding sessions required usually ranges from 3-4 when started this young.

We have still seen excellent results when molding is started later than this.

In these cases, a longer treatment time is needed in order to produce the desired result that will be lasting.

If your infant was premature, their ears will be softer for a longer period of time and therefore remain amenable to molding.

Once your child is older than a few months of age, it is more difficult to obtain good results from ear molding.

Your child may be better served with surgery at a later time, around 6 years of age.

The reason for starting early is that in the newborn, the levels of circulating maternal estrogens are high.

It is these estrogens that keep the cartilage soft.

After 6 weeks, the estrogen levels go down, and the cartilage is not as soft.

Breastfeeding can provide some maternal estrogens which may help to keep the cartilage softer.

Some ear deformities will correct on their own; most will not.

70% of ears deformed at birth will either stay the same or worsen.

If they do correct, it is nearly always a mild deformity that corrects within the first week or two of life.

It is best for your child to be closely observed during this critical time.

If your infant’s ears do not seem to be correcting, ear molding may be recommended.

Treatment Differences: Ear Deformations and Malformations

When the ear cartilage is misshapen and all of the cartilage and skin of the ear are present, this is considered a deformation.

Deformations can be treated with ear molding or with ear reshaping surgery.

Mild deformations may correct on their own in the first week or two of life.

When the ear has parts of the cartilage and skin missing, this is considered a malformation.

A malformation typically requires reconstruction of the ear in order to replace the missing parts.

What if my child is not a candidate for ear molding?

If your infant or child is too old for ear molding, an ear reshaping procedure known as otoplasty can be done.

Otoplasty is an outpatient procedure that corrects the ears in one session.

Read more about Otoplasty here. If your child is not a candidate for ear molding because they have microtia and require ear reconstruction, they may have microtia repair later in life.

Dr. Melinda Costa has extensive experience with neonatal ear molding, a non-surgical office procedure used to reshape infants’ ears to a normal appearance.