Ear Molding: Caleb’s Story

When the doctor handed Caleb to her for the first time, Lauren Weinberger gazed at her brand-new baby boy adoringly, soaking up every detail — right down to the 10 tiny toes she counted. Then, she noticed something. “Look how flat his ears are!” she said to her husband.

Caleb Ear Molding Caleb’s ears were squared off at the top, instead of rounded. One ear had more of this “flattened” look than the other.

“At first, I thought his ears might have gotten squished during the birth process,” recalls Lauren. “But they stayed that way.”

After bringing Caleb home and getting settled into their new routine as a family of three, Lauren tried to push her concerns to the back of her mind. The difference wasn’t too drastic, and she worried more about the idea of putting Caleb through surgery than the look of his ears.

But Lauren couldn’t shake the feeling that there might be something they should do. “I just kept thinking about the future,” she says. “I imagined Caleb being made fun of at school, and I wanted to protect him from that.”

Lauren decided that if her ears had looked that way, she would’ve wanted her own mother to try to fix them. That was the tipping point.

Ear molding: an alternative to surgery

An online search for “flat ears” led Lauren to a message board where another mother described how her baby’s flat ears were treated with ear molding. Ear molding is a nonsurgical technique that works by forming misshapen ears into a more normal ear shape. It can be used to correct a number of congenital ear deformities, including ears that stick out (protruding ears), pointy ears (Stahl’s ear), or ears that are folded over or otherwise misshapen, as in Caleb’s case.

Lauren found information about ear molding on the Children’s Hospital of Philadelphia’s website, and the more she read, the more it sounded like Caleb’s ears might benefit from this nonsurgical treatment. Her hesitation turned to hope: no needles, no surgery.

Right ear with ear molding in place. Right ear with ear molding in place. The one catch, as far as she could tell, was the recommended treatment window: the earlier, the better. Ear molding works best in the first few weeks of life. During that window, ears are soft and pliable because maternal estrogen is still in the baby’s system from birth. This means infants’ ears are very soft and moldable, which is what allows them to be reshaped. Caleb was already a month old by the time he arrived at CHOP in early March 2016.

The Weinbergers met with a nurse, who took pictures of Caleb’s ears, and Scott P. Bartlett, MD, chief of the Division of Plastic and Reconstructive Surgery. Dr. Bartlett explained to the Weinbergers that Caleb had a congenital ear deformity in which the outer rim of the ear is folded and pleated, often called a helical rim deformity.

After examining Caleb’s ears, Dr. Bartlett explained that one ear would likely respond better than the other simply because there was less cartilage to work with on one side, but that Caleb was still a good candidate for ear molding. He got to work, custom fitting the devices to Caleb’s ears right then and there.

Ear molding uses a combination of external ear molding devices, one designed by CHOP experts themselves, and dental impression material, to slowly reshape the ear. In most cases, the earlier treatment begins, the shorter the time the devices need to be worn. Dr. Bartlett sent Caleb home with instructions to return in two weeks for a reevaluation.

Reshaping Caleb’s ears

Caleb took to the devices like a champ. He didn’t love sitting still while everything was put in place, but once the devices were actually on his ears, Caleb didn’t fuss at all.

“He never even grabbed for them,” says Lauren. “He slept great and acted like his usual happy self. We started thinking of them as his ‘braces’ — but without the pain that goes with braces for the teeth.”

When they returned to CHOP two weeks later, the Weinbergers were shocked at Caleb’s progress. “I couldn’t believe his ears had changed so much already,” says Lauren.

As Dr. Bartlett predicted, however, one ear had responded better than the other. New pictures were taken and new devices were fitted to Caleb’s ears for the next two weeks.  

Patient ear molding before and after left view

Left Ear Before and After Ear Molding Treatment

Patient ear molding before and after right view

Right Ear Before and After Ear Molding Treatment

At Caleb’s next appointment, Dr. Bartlett removed the devices for good. At the big reveal, “Caleb’s ears looked great — no more flatness! It was such a drastic difference!” says Lauren joyfully. The ear that had less cartilage to work with was still slightly squared off, but the difference was noticeable only to a mother’s discerning eye. “People don’t notice it,” says Lauren. “Only I do, if I really inspect it.”

Having ears that are unnoticeable — unremarkable — is exactly what they were hoping for.

“We’re just happy that we did what we could now to prevent kids from potentially making fun of Caleb’s ears someday, and that we were able to do it with a procedure that was painless for him,” says Lauren.

Originally published August 2016

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