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Earwell Newborn Ear Correction: Dr. Fishman’s TOP 6 Pearls for Success

Newborn ear correction is an effective treatment for many congenital ear deformities.  This treatment, originally described in the 1980s, is commonly performed at Aviva Plastic Surgery by our Facial Plastic Surgeon Dr. Inessa Fishman, who has practiced newborn ear correction since 2014.  “As a Board Certified ENT, I’m very comfortable with ear anatomy and have assisted on and performed hundreds of ear surgeries on babies and children,” says Dr. Fishman.  “I really enjoy the nonsurgical newborn ear correction aspect of my practice, because it allows for some beautiful results, the potential avoidance of surgery and teasing, and some very happy parents,” she explains.

With an average of 2-5 patients a month undergoing newborn ear correction at our clinic, this treatment is familiar to us.  However, we meet lots of parents, family members, and healthcare providers who don’t know about newborn ear correction, and with this in mind, we asked Dr. Fishman what our patients’ families and caregivers need to know.

Newborn ear correction is a time-sensitive treatment, best performed before the baby gets to 6-8 weeks of life, explains Dr. Fishman.  “High level of Mom’s estrogens in the baby’s system make the cartilage of the ear soft and pliable,” she outlines, “and because these estrogens drop off around 2 months after birth, ear splinting or correction is best done well before this.”  It is a painless and non-invasive treatment, similar to putting on and removing a band-aid.  “I do newborn ear correction with a splinting system called Earwell and frequently supplement or modify with custom silicone splints I make myself,” Dr. Fishman says, “but it’s important to note that it’s not the splint material that really makes a difference–it’s simply the concept of holding the ear in the desired shape for a few weeks.”

Dr. Fishman’s recommendations for the best newborn ear correction treatment are as follows:

1 Start early

Recognizing an ear deformity and treating it early are key, says Dr. Fishman.  “My personal practice is to give babies a week of life to see if the ear deformity self-corrects or resolves, and if it doesn’t, I prefer to treat the baby,” she explains.  Ideally, babies make it to our clinic for treatment within the first 1-3 weeks of life.  The chance of successful treatment drops off around 6-8 weeks of life.  Starting treatment later “decreases our chance of a good outcome and potentially sets up the baby for a longer course of treatment,” says Dr. Fishman.


2 Get your newborn photos done before your appointment

Dr. Fishman shaves a wide strip of hair around the affected ear before treatment, and both the Earwell and custom ear splints are visible when placed onto the treated ear.  Make sure that you have your newborn’s photos done or on the schedule before you come and see us for treatment so the splints don’t affect the photos, says Dr. Fishman.


3 Do your homework about your insurance plan

Our practice does not contract with insurance; however, some insurance plans do cover the newborn ear correction treatment.  Please call your insurance provider and ensure you have the necessary information to make the best treatment decision for your baby before your consultation.  “If a baby needs treatment, I’ll recommend and start treatment at the baby’s initial clinic visit,” says Dr. Fishman, noting that early treatment is key to a successful outcome.  If your insurance coverage will affect your treatment decisions, please contact your insurance provider with diagnosis code Q17.9 and Procedure/CPT/service code 21086 before your consultation.


4 Learn as much as you can about newborn ear correction before your visit

Well-informed patients and parents of patients make well-informed decisions.  While the newborn ear correction treatment is elective, there’s a limited window of opportunity for this treatment, and it requires the investment of time and care on the part of the baby’s caregivers.  “I ask parents and caregivers to check the splints, keep them dry, and come back to see me in the clinic a few times every 10-14 days,” says Dr. Fishman.  Other treatment options, like Earbuddies and double-sided sticky tapes, may be reasonable alternatives to treatment in our clinic; the Earbuddies system is purchased online and is meant to be placed by parents or caregivers.  The most common risk of newborn ear correction is skin redness and irritation from tape or cleaning agents, says Dr. Fishman, and this is something that resolves within a few days of removing the splint.  Infections and scarring are uncommon with newborn ear correction. Newborn ear splinting does not affect how the treated baby hears, eats, and sleeps.  “I review the details, benefits, risks, and expectations of newborn ear correction during my consultation,” says Dr. Fishman, “and I find that well-informed caregivers tend to be less nervous about treatment and more certain about their treatment decisions.”


5 Bring a well-fed baby

Newborn ear correction is not painful.  Some babies cry during the hair trimming, skin cleaning, or splint placement, and some babies will express displeasure with simply being held in a way they don’t like.  Babies that have recently eaten tend to sleep through treatment, and this seems to decrease caregiver worry.  “We try our best to accommodate little ones and their families in our clinic,” says Dr. Fishman, recommending caregivers arrive early for their appointment, and take plenty of time for diapering, breastfeeding or bottle-feeding, and burping before treatment.


6 Get ready to answer lots of questions from family and curious strangers

Our families commonly get questions about ear splints, why they are necessary, and how long they will be worn from family members, friends, healthcare providers, and sometimes strangers who see babies in the midst of treatment.  Beyond this, some online communities question the need for newborn ear treatment and tout the importance of individual differences above all else.  The decision to engage in these conversation is of course yours, and if you want to avoid these discussions, cover your baby’s ear splints with a cute hat or headband when you’re out and about, says Dr. Fishman.


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