Otoplasty – among the positive outcomes is bullying prevention

Congenital ear deformities are those that appear at birth and can be relatively common. Small details or asymmetries, and of course there are different degrees, can even go unnoticed.

There are cases where the baby is born without an ear (anotia), which is extremely rare, or with only vestiges of an ear to different degrees, called microtia.

One of the most common alterations is prominent ears (otapostasis), when there is a greater distance of the ear from the head, in addition to an effacement of the antihelix shape (the internal fold of the ear that has a Y shape).

There are other types of less frequent deformities resulting from partial or insufficient development such as: constricted ear, in which it is folded and closed (in a shell-like shape), and cryptotia, in which the ear is hidden under the skin.

It is important for parents to investigate, as ear deformities can be related to diseases and syndromes, and even to hearing impairment.

Just the way the child is positioned in the womb (during pregnancy) and during birth can be the cause of some deformities, but it is not uncommon for the baby to be born all crumpled and the ear gradually adjusts.

In the first days and weeks of life, mainly due to the influence of maternal hormones, the cartilage is still malleable, which allows for some conservative treatments. It is possible to make molds using cotton and adhesive tape (e.g., Micropore) which can aid in ear molding. There is also a pre-made silicone mold for this purpose.

The ear finishes its development around seven years of age, which allows for early surgery for small significant alterations such as prominent ears. Some prefer to perform otoplasty around five years of age, before school age, to avoid social embarrassment due to bullying.

More significant deformities may require several surgical stages for full ear reconstruction. In all proposed surgical treatments, it is important to bring the child to participate and interact in the decisions. Their participation in this phase can be fundamental for a good post-operative recovery. 

*Dr. Fernando Amato is a plastic surgeon, a full member of the Sociedade Brasileira de Cirurgia Plástica, a member of the Sociedade Internacional de Cirurgia Plástica Estética (ISAPS) and the Sociedade Americana de Cirurgiões Plásticos (ASPS).