The newborn butterfly project: a shortened treatment protocol for ear molding

Plast Reconstr Surg. 2015 Mar;135(3):577e-583e. doi: 10.1097/PRS.0000000000000999.


Background: Secondary to circulating maternal estrogens, a baby's ear cartilage is unusually plastic during the first few weeks of life, providing an opportunity to correct ear deformities by molding. If molding is initiated during the first days of life with a more rigid molding system than previously described in the literature, the authors hypothesized that treatment time would be reduced and the correction rate would increase.

Methods: An interdisciplinary team identified and assessed all infants born with ear deformities at New York-Presbyterian Hospital/Weill Cornell Medical Center. The authors conducted a prospective, institutional review board-approved study on the first consecutive 100 infants identified. Parents were surveyed initially, immediately after treatment, and at 6 and 12 months.

Results: One hundred fifty-eight ears in 96 patients underwent ear molding using the EarWell Infant Ear Correction System. Eighty-two percent of the children had the device placed in the newborn nursery and 95 percent had it placed before 2 weeks of life. Average treatment time was 14 days, and 96 percent of the deformities were corrected. Complications were limited to mild pressure ulcerations. Ninety-nine percent of parents stated that they would have the procedure repeated.

Conclusions: The molding period can be reduced from 6 to 8 weeks to 2 weeks by initiating molding during the first weeks of life and using a more secure and rigid device. Through an interdisciplinary approach, the authors were able to identify patients and to correct the deformity earlier and faster than has been previously published, eliminating the need for surgical correction in many children.

Clinical question/level of evidence: Therapeutic, IV.

MeSH terms

  • Congenital Abnormalities / surgery*
  • Cosmetic Techniques*
  • Ear Auricle / abnormalities*
  • Ear, External / abnormalities
  • Female
  • Follow-Up Studies
  • Humans
  • Infant, Newborn
  • Male
  • Plastic Surgery Procedures / methods*
  • Prospective Studies
  • Retrospective Studies
  • Splints
  • Surgical Tape
  • Treatment Outcome