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Houston Cranio Facial

Infant Ear Molding and the EarWell™

Infant ear molding is a non-surgical restorative technique designed to reshape a newborn’s ears. Babies’ ears can have deformities that do not self-correct on their own shortly after birth. The cartilage is soft and pliable in infant ears for the first couple of weeks of life. By molding the ears with specially-shaped soft plastic and silicone, the normal shape can be formed without ear surgery — known as otoplasty. It is important to address these concerns as early as possible for the best result, so if you believe your infant can benefit, or if a pediatrician has noticed an abnormality or if you have a referral, please contact our practice for swift assistance.

How are Ear Deformities Corrected?

In the past, the suggestion was to just allow the ears to naturally form the normal shape of the ear with time and growth. We have learned that about 15% of children are born with ear deformities, and the majority of them do not resolve with time. The parents were then told to wait until the child is between the ages of five and seven years old before having surgery. Otoplasty surgery for a child can be tough since it is painful. Sometimes the child has already undergone repeated insults from other children in regard to their ears.

Recently there has been a new push for non-surgical correction of infant ears with molding techniques because they are pain free. The technique has been simplified by using a device invented by Dr. Steve Byrd called the EarWell™ Infant Ear Correction System. This device is placed around the ear and the child is treated for about six to eight weeks. It is important to start the treatment during the first few weeks of life to get the best results. If the child is older than a month old, the success of treatment using the EarWell™ device drops significantly. Therefore, we believe in only treating very young infants with these molding techniques within the first week of life after birth. Unfortunately, this leaves only the surgical option if the infant is older than a several months old.

What is Infant Ear Molding?

Infant ear molding is a non-invasive technique performed to correct deformities in the ear shape while the cartilage is still pliable. This correction is achieved through placement of a special ear molding device worn for an extended period of time, effectively reconstructing the ear proportions without an invasive procedure. We believe that this technique provides a non-surgical correction that is as good or better than surgery. Dr. Payne, our extensively trained craniofacial plastic surgeon has been trained in Dallas, Texas by the inventor of the EarWell™ Infant Ear Correction device, Dr. Steve Byrd.

In order for ear molding to be maximally effective, the treatment begins in the first two weeks of life. Make an appointment today for your newborn infant ear evaluation with Dr. Eric Payne at our state-of-the-art practice.

How Does the EarWell™ System Remold the Ears?

Ear deformities can be easily corrected if diagnosed early in infancy. Using molding techniques such as the EarWell™ Infant Ear Correction System, we can restore the normal ear anatomy without surgery. The cost, pain, and risk of anesthesia are potentially eliminated with this technique if it is successful. The EarWell™ Infant Ear Correction System is made up of four pieces:

  • Posterior shell with posterior conformer
  • Helical rim retractors
  • Conchal former
  • Anterior shell

Each piece is carefully placed in order to gently reshape the soft ear tissues. The design is tailored to babies’ needs, including comfort and safety. Sometimes additional soft silicone putty is added to help with reshaping the ear. An adhesive holds the apparatus in place, and the flexible plastic shell works in combination with a special molding putty to achieve the desired outcome. You will be present while our physician places the EarWell™ system, so you can see exactly how each layer contributes to the final result. Each ear mold is carefully designed and placed to correct each individual ear anomaly.

Types of Ear Deformities

Stahl’s Ear

Commonly known as “Spock Ears” or “elf ears,” the helical rim is deformed and flattened, which is caused by a third crus. The appearance is of a pointed ear shape at the top of the ear.

Lidding

In lidding, the upper portion of the helical rim is collapsed due to lack of support from a superior crus. This causes the appearance of the ear being folded over the top. Lidding occurs in about 27% of infant ear deformities.

Lop Ear

Lop ear is a folding over of the upper third or half of the ear. It is very similar to lidding but is much more severe.

Cryptotia

Cryptotia is defined as a portion of the ear cartilage buried beneath the skin. Usually cartilage is not missing, but the cartilage is compressed and deformed. There is missing skin behind the ear, which makes wearing glasses difficult. This type of congenital ear deformity is a functional problem.

Helical Rim Deformity

The helical rim is distorted and abnormally shaped.

Constricted Ear Deformity

There is an absence of skin and/or scapha causing a constriction deformity of the ear. The constricted ear can be mildly, moderately, or severely deformed.

Prominent Ear

The most common deformity is the prominent ear. The ear projects away from the head causing an appearance of larger ears. A more severe variation of prominent ears is called a “Cup Ear.”

Conchal Crus

A ridge of the conchal, or bowl, of the ear is present, causing a more prominent ear deformity.

Inverted or Anteverted Conchal Bowl Deformity

The conchal bowl near the ear canal is convex instead of concave, causing narrowing of the ear canal and making it difficult to hear or remove wax, which can build up and cause hearing loss. This is also known as a Mozart Ear Deformity, since Mozart also had his left ear affected in the same way. Interestingly, his son also had a left ear inverted conchal bowl ear deformity, suggesting a genetic component to this type of functional ear deformity. The true cause is likely seen as an abnormal intrinsic auricular muscle located along the posterior aspect of the cavum conchae.

How Does Infant Ear Molding with EarWell™ Work?

The first step is to prepare the ear for the device, which means to shave an area around the ear so the adhesive will hold well. The posterior shell, or cradle, will then be placed over the ear and adhered to the skin. The retractor is then placed, and this apparatus is used to shape the rim of the ear. The conchal former is then attached, and it is utilized to shape the center of the ear. Additionally, soft silicone putty can be added and shaped, then allowed to harden into a custom mold that will improve the shape of the ear. Finally, the anterior shell, or cover, is added last to secure the EarWell™ system together. Since the cartilage and tissues on the infant are so soft, the EarWell™ can modify the shape of the ear simply by holding it in the optimal position for an extended period. Essentially, the custom molds act like splints for the ears. Our skilled medical team will monitor your child’s progress during treatment to ensure the process is working or determine if another technique may be needed. As many as 90% of children can obtain excellent results from the EarWell™ system if used within the first eight weeks of life.

What Results Can I Expect with the EarWell™ Infant Ear Molding System?

EarWell™ is often very successful for newborns who are evaluated for treatment in the early stages of infancy. This can be due to the levels of maternal estrogen that remain in the baby’s bloodstream. Proper reconstruction of the ear anatomy is usually attained in about six to eight weeks, although each patient’s treatment plan will differ. Most importantly, the outcome of treatment can last a lifetime and children who previously suffered from an ear deformity do not have to contend with concerns associated with an irregular or asymmetrical ear shape, such as teasing from peers and self-consciousness. There is usually no need for retreatment or surgical intervention in the future as long as patients were under the care of a qualified infant ear molding specialist. Dr. Payne will provide you with more information regarding what types of results you can expect from EarWell™ during your initial consultation.

Who Should Perform Treatment with EarWell™?

We understand that every parent aims to seek out the best possible care for their child, whether their needs are medical or cosmetic in nature. It is with this understanding that we strongly advise parents to enlist an experienced EarWell™ provider to properly correct their newborn’s ear shape. Dr. Eric Payne’s credentials as they relate to infant ear molding treatment are unrivaled:

  • Dr. Payne was trained under and mentored by the inventor of EarWell™, Dr. Steve Byrd: The techniques Dr. Payne utilizes during treatment with EarWell™ were learned directly from the inventor of the device himself, who pioneered infant ear molding as a non-surgical approach to repairing ear deformities in children.
  • Dr. Payne is certified by the American Board of Plastic Surgery in plastic and reconstructive surgery: Plastic surgeons are not required to attain accreditation by the ABPS; however, board certification signifies a higher level of training in plastic and reconstructive procedures, as well as a greater commitment to staying up-to-date with the most effective techniques. Dr. Payne also has privileges at Texas Children’s Hospital, The Shriners Children’s Hospital Texas, and Memorial Hermann Children’s Hospital.
  • As a craniofacial plastic surgeon, Dr. Payne specializes in reconstructing the anatomy of the skull, head, and face: Dr. Payne has spent his entire career focusing exclusively on craniofacial plastic and reconstructive procedures, giving him a more robust understanding of correcting the anatomy of the ears. Dr. Payne treats all types of ear malformations and ear deformities including, microtia reconstruction and otoplasty procedures.
  • Dr. Payne has ample experience correcting congenital ear deformities in children on a national and international level: Dr. Payne has traveled around the world extensively to provide reconstructive care to children in underserved communities, repairing birth defects that range from cleft lip and palates to skull deformities.

    • As with any medical procedure, the results of treatment are only as successful as a plastic surgeon’s level of skill and experience performing the technique. We encourage you to schedule a consultation with Dr. Payne to learn a little more about the EarWell™ device, discuss his experience helping infants achieve natural-looking ear proportions, and determine whether your child is a good candidate for infant ear molding.

    Have additional questions about the EarWell™? Contact our practice today to learn more and to schedule a consultation with Dr. Payne.