Prominent Ears, Small Ears and Skin Tags: When Is Surgery Necessary for an Ear Condition?

Ear differences such as prominent ears, small/underdeveloped ears (microtia) and skin tags (also known as branchial remnants) can cause worry and distress to children and families. As a plastic and reconstructive surgeon, I often hear questions from parents related to hearing and surgery – here are some of the common ones.

Question #1: Does My Child’s Ear Difference Affect His or Her Hearing?

Every child should have a newborn hearing screening regardless of whether or not the child has an ear anomaly. Prominent ears and branchial remnants do not typically cause any abnormality of hearing.

Small/underdeveloped ears can be associated with middle ear hearing issues.  These children should be seen by an otolaryngologist (ear, nose and throat doctor) specializing in hearing (an otologist). Special hearing studies may be required to determine your child’s ability to hear out of the affected ear.

Question #2: What Treatment Options Are Available for My Child’s Ear Condition? Does My Child Have to Have Surgery?

The options for treatment depend upon the underlying condition.

Skin tags – For skin tags, surgical removal tends to be the best treatment option in terms of scarring and healing. Most providers do not recommend, “tying them off”. Your child does not have to have surgery unless the skin tags become irritated from pulling or tugging on them.

Prominent ears - Several options exist for treatment of prominent ears. Some families elect to perform ear molding within the first week or two of life. This process involves a corrective mold being worn 24 hours a day, 7 days a week for typically 6-8 weeks. This process is non-surgical but requires frequent (typically weekly) visits to a provider.  If your child is older, prominent ears are typically corrected surgically around school-age. This procedure is an outpatient procedure with the child going home the same day of surgery. Surgery for prominent ear deformity is elective and should be discussed with your a physician.

Small or underdeveloped ears - This condition can affect the external and internal components of the ear. An otologist can address the best options to help your child.  The external ear can be reconstructed by using the child’s ribs, using an implant, or using prosthesis. Your treating physician can discuss the various treatments, including the risks and benefits, to determine the best option for your family.  External ear reconstruction is elective and should be discussed with your treating physician.

Question #3: Will Insurance Cover My Child’s Ear Condition?

Insurance coverage is dependent upon the type of ear condition, whether hearing is affected and the individual’s policy. Your treating physician’s office should help you determine if your policy covers the condition

Question #4: What If Insurance Does Not Cover the Condition and It Bothers My Child?

If your child’s ear condition is not covered by medical insurance, then it would be considered cosmetic surgery. Your treating physician should discuss the costs associated with treating your child’s ear deformity.