You know Barack Obama as a dignified former US president but, as a kid, his larger-than-average ears made him a prime target for teasing and taunts, he once revealed at an anti-bullying conference.
First-time mum Dawn Ching felt that fear when her baby, Oliver, was born with irregular-shaped ears. She had them corrected when he was just six days old so they would look “normal”.
Oliver had a condition known as lidding in both ears, where the top part of his ears was folded over. There was also an abnormal fold of cartilage across his ears.
“Although my mother said he might outgrow it, I didn’t want to take the chance,” shares Dawn, 30, a tax manager. “There was nothing wrong with his hearing, but we were worried that he might be bullied or teased for his ears by other kids when he starts school.”
Ear deformities are common in babies. About a third of all newborns have them, says Dr Chia Hui Ling, associate consultant at the Department of Plastic, Reconstructive and Aesthetic Surgery at KK Women’s and Children’s Hospital (KKH).
Common issues include ears that stick out too much, appear pointed, rolled over or flattened. The child’s ear may also appear partially buried under the side of the head. In severe cases of ear deformities, the child may significantly lack ear cartilage and/or skin, or has no ear at all, Dr Chia shares.
Although most ear deformities do not usually affect the child’s health and can be left alone, parents are now more active in seeking treatment to reshape their babies’ misshapen ears.
Dr Lee Hanjing, an associate consultant at National University Hospital’s (NUH) Division of Plastic, Reconstructive and Aesthetic Surgery, attributes this in part to today’s “more socially aware culture” and parents being “financially comfortable”.
Mould me a perfect pair
Plus, a new non-invasive treatment has made the process of reshaping ears a lot simpler. Using a moulding technique known as the Earwell Infant Ear Correction System, most young babies with ear deformities do not have to go under the knife.
The treatment involves wearing a splint over the ear for a few weeks. But it cannot fully correct more severe deformities – for example, when there is a significant lack of ear cartilage and/or skin, Dr Chia says. Surgery is still required for such cases.
Oliver is one of the babies who have undergone the treatment at KKH. Its doctors have used the technique on over 100 infant ears over the past three years. Earwell is also available at NUH now.
“Parents who know about the treatment are usually agreeable to ear moulding because it involves wearing a corrective splint for a few weeks,” says Dr Chia of KKH. She adds that no surgery is required, but the splint must be applied by a trained practitioner.
However, the experts point out that the number of cases they see still lag behind the actual number of babies born with ear deformities, due to a lack of awareness about treatment.
Some parents also mistakenly think that their babies’ ears self-correct over time when, in fact, most of these ear deformities either remain as they are or may worsen with age, Dr Lee says.
No surgery required
According to Dr Chia, the non-surgical method is “very effective” in correcting most ear deformities: The success rate at KKH is over 90 per cent. The results after treatment are also permanent.
The catch, however, is that it should be done within the first six weeks of life, preferably when the baby is only a few days old, says Dr Chia.
“It is best placed within 72 hours of life as the ear cartilage is soft and easily mouldable. Ear moulding can be carried out on babies who are up to three to four months old, but the later the treatment starts, the less successful it will be,” adds NUH’s Dr Lee.
Babies who do not take well to splinting are typically those who started the moulding too late or have more severe ear deformities, says Dr Chia.
For parents looking for a painless way to correct their babies’ irregular ears, the simple method is a game changer.
One mum, Angela Tan (not her real name), was sold on the idea that the treatment did not require her baby to go under the knife. Her baby’s right ear was partially buried under the side of his head, a condition known as cryptotia.
“Myopia runs in the family and I was worried that my child might have problem wearing spectacles in the future because of the shape of his ear,” says the 40-year-old engineer whose child is now 14 months old. “We did the ear-moulding treatment there and then at our first consultation when my baby was around six weeks old.”
Dawn says that other than the minor inconvenience of weekly follow-ups at the hospital every week, the treatment did not hurt or bother Oliver, who wore the splints for four weeks.
“I’d probably have a lot more reservations if the treatment required him to undergo surgery,” she adds.
For babies who miss the golden window of opportunity to do ear moulding, there’s still the option of a nip and tuck, usually done after the age of four years.
But as with any surgery, there are some risks involved such as bleeding, infection and complications from wounds. Children typically face greater surgery risks than adults, Dr Lee says.
Surgery is also costlier than ear moulding – at least a few thousand dollars, depending on the types of deformity and subsidy that the patient is eligible for, Dr Chia explains.
Earwell, on the other hand, will set parents back by about $500 per device and application. A child typically needs more than one device for the entire treatment period, Dr Chia says.
Still, some parents choose to put their children under the knife for various reasons, among them the fear of bullying and concerns about poor self-esteem. In some cases of facial deformities, such as a cleft palate or lip, there may be a medical need and correcting them helps the child function better.
KKH’s Department of Plastic, Reconstructive and Aesthetic Surgery performs about 20 cases of surgery for ear deformities every year. Over at the NUH, about 50 surgeries for ear deformities were carried out in the past two years.
Some studies have shown that people with ear deformities often experience bullying and teasing that may affect their emotional well-being. KKH’s Dr Chia has encountered kids who suffer from anxiety due to their facial or ear deformities. When this happens, the child may be referred for psychology therapy.
Dr Lim Boon Leng, a psychiatrist at Dr BL Lim Centre for Psychological Wellness, says young kids may not be “cognitively sophisticated” enough to truly understand values and concepts
such as acceptance.
“The child may find it difficult to make friends, become ostracised for being different and face a high chance of being bullied,” he explains.
Sometimes, parents unwittingly add on to the anxiety and social stigma by over-emphasising the child’s irregular facial feature. For instance, they may talk about the deformity negatively or ask the child if he wants it corrected. They may also look at and touch it excessively, Dr Chia shares.
According to Dr Lim, correcting a genuine facial anomaly can make a huge difference to the child’s emotional well-being – he integrates better with peers which, in turn, prevents low self-esteem in the future, as well as other possible psychological issues like depression.
But Dr Lim personally draws the line at fixing “normal variants”, such as ears that are more pointed or protrude more than usual.
He points out: “These are often driven by the current fashion or aesthetic sense that may pass. Who is to say that a more pointed ear will not be considered a beautiful attribute 20 years down the road when the child grows up?”
Even so, there are no easy answers. Dr Lim says parents have to judge for themselves if correcting the child’s facial differences will benefit his well-being in the long run.
One thing’s for sure, though. “If parents themselves are not able to make peace with their child’s differences, their rejection will be the most detrimental psychological damage a child can receive,” he says.
Now 11 months old, Oliver’s post-treatment ears look perfectly “normal”, much to Dawn’s relief. In an ideal world, she agrees that everyone should embrace unique differences among individuals. But the reality of human interaction is often way more complex.
“Kids, being kids, may not understand this,” she says. “Oliver is my son, and if I can control the situation now (with treatment), why not?”