Ear deformities

Ear deformities are usually congenital, meaning you are born with them. However, some ear deformities can occur later in life due to trauma or injury.

At Guy’s and St Thomas’ Specialist Care, our plastic surgery specialists provide both surgical and non-surgical solutions to correct ear deformities in adults and children.

What are ear deformities?

An ear deformity is a condition where your ear has an unusual shape. For example, it could be small and underdeveloped, or may be prominent and stick out.  

Most ear deformities are cosmetic in nature, but some may result in hearing loss which can lead to delays in a child’s development.   

Types of ear deformities 

There are many different types of ear deformities, but they fall under two groups – congenital and acquired.

Congenital ear deformities

Congenital ear deformities are present at birth. They are common, affecting 1 in every 6,000 babies.  

Typical congenital ear deformities include:  

• cupped (constricted) ears – the ear’s upper rim is tight, folded or wrinkled 
• protruding ears – the ears stick out more than 2cm from the side of the head 
• microtia – an underdeveloped outer ear  
• anotia – an ear or ears are missing 
• cryptotia – ear cartilage that’s partially under the skin 
• Stahl’s ear – causes pointed ears and sometimes an additional fold of cartilage on the outer ear 
• ear tag (accessory auricle) – a ‘tag’ or growth of excess skin and cartilage on the ear 

Our plastic surgeons can correct some types of congenital ear deformities with non-surgical treatments, such as ear moulding. This is performed in the first few weeks after birth.  

However, some congenital ear deformities may require surgery for correction, in which case plastic surgeons wait until children are older – usually over the age of 5.  

Acquired ear deformities

An acquired ear deformity is one that happens later in life, typically due to an injury or trauma. 

Common acquired ear deformities include:  

• cauliflower ear – often seen in boxers and people who participate in contact sports. Blood collects between the skin and cartilage, causing a bulbous appearance
• ear keloids – piercings can lead to an overproduction of scar tissue that creates a raised dark bump
• haemangiomas – non-cancerous growths made up of blood vessels
• split earlobes – wearing heavy earrings consistently or wearing ear stretchers that are too big can split your earlobe

Some people feel less confident because of their acquired ear deformity and may consider treatment. Reconstructive procedures can help to achieve your desired look. 

Symptoms of ear deformities

Not all ear deformities cause symptoms, but they can include:  

• chronic ear infections
• hearing loss
• speech problems

Children with congenital ear deformities may experience delays to their development if they have hearing loss.

Causes of ear deformities

Congenital ear deformities occur while a baby is in the womb. The cause is unclear, but experts believe it may be a result of genetic disorders (passed down from biological parents to their child) or a lack of blood supply during fetal development (possibly due to the position of the baby in the uterus).  

Acquired ear deformities can be caused by trauma or injury, as well as certain cancerous and non-cancerous growths. 

Ear deformity diagnosis

Generally, doctors can diagnose congenital ear deformities at birth by physically examining a baby’s ear. Our Well Baby Clinic at Evelina London Children’s Hospital provides parents with expert guidance at key milestones during the first year of your baby’s development. Each clinic includes one of our plastic surgery specialists who can diagnose an ear deformity and provide a recommended treatment.  

Sometimes, an ear deformity may not be evident until your child is older or if it causes them problems, such as ear infections. A doctor can also perform a physical examination if you or your child develop an ear deformity later in life. Other investigative tests may be carried out, depending on the type of ear deformity or cause.

Ear deformity treatment

Treatment for ear deformities depends on the type and your age. For example, children under 5 cannot have surgery to correct an ear deformity as their ears have not finished growing and the cartilage is too soft to hold stitches. 

Our team of plastic surgery specialists will recommend which treatment is best from a range of surgical and non-surgical options, that include: 

• ear moulding: If a congenital ear deformity is diagnosed at birth, ear moulding is a non-surgical treatment that can correct it within the first few weeks of life. A custom-made mould is created that is placed over your baby’s ear. This gradually changes its shape over time – typically over 2 to 4 weeks 
• pinnaplasty (also called ‘ear pinning’ or otoplasty) is a type of cosmetic ear surgery that changes your ear’s shape, size or position. It can treat Stahl’s ears, cupped ears and protruding ears. Surgeons can only perform pinnaplasties once your ears have reached near their full size, usually when your child is 5 years or older. This procedure is performed with general anaesthetic 
• surgical excision can be used to treat an ear tag, where it is surgically cut away. This procedure can be performed under local anaesthetic when under 6 months of age or when the child is mature enough. If your child is aged between 6 months and 5 years old, they will usually need a general anaesthetic so that they keep still 
• laser treatment or steroid injections may be recommended for a keloid scar on the ear. 
• cauliflower ear can be treated by draining the accumulated blood in the ear, after which a compressive dressing is applied. However, some types can only be treated surgically 
• split earlobes are surgically repaired. During treatment, a plastic surgeon cuts the divided part of the earlobe, before bringing together the two sides and fusing them with absorbable stitches