Infant Ear Molding and Microtia Reconstruction in New York City
Mingyang Gray, MD, MPH, is a facial plastic and reconstructive surgeon at Mount Sinai who treats congenital ear anomalies, from newborn ear molding to microtia reconstruction. She sees patients at Union Square and E. 85th Street in Manhattan.
Infant ear molding
Some infants are born with ears that are folded, cupped, pointed, or overprojected. Alhtough it is possible that some anomalies correct on their own, many do not. Ear molding can reshape the ear with a small, custom-fit device worn over the ear for several weeks, so the child may avoid surgical correction later in life.
Dr. Gray uses the EarWell Infant Ear Correction System.
Why timing matters
Right after birth, a baby's ear cartilage is soft because the mother's estrogen is still in the baby's system. These levels fall over the first weeks, and by about 6 weeks of age the cartilage becomes firmer and much harder to reshape. The best results come when treatment begins in the first 1 to 2 weeks of life.
If you notice anything unusual about your newborn's ear, call for an evaluation as soon as possible.
Ear shapes that ear molding can treat
- Prominent or protruding ears
- Lop ear (the top of the ear folds down)
- Cup ear and constricted ear
- Stahl's ear (an extra fold that makes the ear look pointed)
- Helical rim deformities (a flattened or irregular outer rim)
- Cryptotia (the top of the ear is tucked under the scalp skin)
What to expect
- Evaluation: Dr. Gray examines your baby's ears and explains whether molding is likely to help.
- Fitting: The mold is placed in the office. It is painless, and your baby can feed and sleep normally.
- Follow-up: Visits every 1 to 2 weeks to check the skin and adjust or replace the device.
- Finish: Most babies wear the device for about 3 to 6 weeks in total.
The most common side effects are skin irritation and small pressure spots, which usually heal once the device is adjusted or removed. In a published series of 184 ears treated with EarWell, about 68% were fully corrected and another 30% were partly improved (Plastic and Reconstructive Surgery Global Open, 2023).
Microtia reconstruction
Microtia is a condition where the ear does not fully form prior to birth. It ranges from a slightly small ear to a small "peanut-shaped" remnant or no ear at all (anotia). It affects roughly 1 in 7,000 to 10,000 newborns and often comes with a narrowed or closed ear canal (aural atresia) and hearing loss on that side.
Rib cartilage ear reconstruction
Dr. Gray reconstructs the ear using the child's own rib cartilage, in two stages:
- Stage one: A small piece of rib cartilage is carved into the shape of an ear and placed under the skin where the ear should be.
- Stage two: About six months later, the new ear is lifted away from the side of the head so it projects like a natural ear.
Because the framework is the child's own living tissue, it grows with the child and holds up well over time. Rib cartilage reconstruction is usually done in school-age children, once the ribs have grown enough to provide cartilage for a full-size ear.
Hearing care comes first
Hearing is checked early in every child with microtia. Dr. Gray works with Mount Sinai's pediatric otolaryngologists, neurotologists, and audiologists so that hearing aids, bone-anchored hearing devices, or ear canal surgery are planned together with the ear reconstruction. Procedures are often combined to reduce the number of surgeries. Learn more about the Mount Sinai microtia and atresia program.
Frequently asked questions
When should my baby be seen for ear molding?
As early as possible, ideally in the first 1 to 2 weeks of life. Dr. Gray starts ear molding in babies up to about 6 weeks old.
Does ear molding hurt?
No. The device is applied without anesthesia, and babies feed and sleep normally while wearing it.
Will my baby's ear fix itself?
Some ear shapes improve on their own, but many do not. Because the window for molding is short, it is better to be evaluated early than to wait.
What if my baby is older than 6 weeks?
Molding is much less effective once the cartilage firms up. Ear shape can still be corrected with surgery (otoplasty) later in childhood, usually around age 5 or older. If you have any questions, please don't hesitate to reach out for a consultation with Dr. Gray.
Is ear molding covered by insurance?
in short, yes. Coverage may vary by plan. Our office can help you check your benefits before treatment.
At what age is microtia reconstruction done?
Rib cartilage reconstruction is usually done in school-age children, when there is enough rib cartilage to build a full-size ear. Dr. Gray will discuss timing at your first visit, and hearing evaluation and restoration starts much earlier.
Is microtia related to hearing loss?
Often, yes. Many children with microtia also have a narrowed or closed ear canal on that side. Dr. Gray coordinates with Mount Sinai Multidisciplinary Microtia/Atresia Team so hearing and ear reconstruction are planned together.
Schedule an evaluation
Mingyang Gray, MD, MPH
Facial Plastic and Reconstructive Surgery, Mount Sinai
New York Eye and Ear Infirmary of Mount Sinai
10 Union Square East, Suite 5D, New York, NY 10003
Phone: (212) 979-4200
Sources: Children's Hospital of Philadelphia, Ear Molding; Mount Sinai, Microtia and Atresia; Plastic and Reconstructive Surgery Global Open, 2023.