Most young children are not concerned about their facial appearance, certainly infants and preschool age children do not typically compare themselves to others, and experience from Microtia clinics tells us that most children below the age of 8-10 years old are simply not interested in any surgical intervention.
Comparing ourselves to others begins in primary school and increases at least into adolescence, with comparisons to peers and celebrities in the media, as well as the influence of comments from peers and family, increasing awareness and judgements about appearance.
There is a strong argument for waiting until the child is old enough, with the necessary level of understanding and emotional maturity, to enable informed decision making.
A study that interviewed adolescents with visible difference found that the children were glad that their parents had allowed them to be involved in the decision making process around surgery.
They also did not feel that concern regarding current or potential bullying to be a good reason to have surgery at a young age, and that promoting self acceptance and resilience to be far more important.
If you are considering surgery for your child, please look at the Ear Reconstruction section of this webpage for information and advice, and tips from parents who have been in this situation.
Many children we see at clinic have no concerns related to their appearance. Coping is linked to personality, family responses, school support and age.
However, some children and young people can struggle in relation to their visible difference. This might be evident in their behaviour, for example:
- wearing hats
- having hair long to cover their ears
- avoiding swimming pools
- avoiding photographs or mirrors
- avoiding questions about their ear or appearance
- avoiding social situations.
They might feel self conscious, angry, sad or worried; have difficulties sleeping or sore tummies related to anxiety.
It is really helpful to talk about their Microtia or visible difference.
We encourage parents/carers to:
- be open and honest
- talk about their child’s condition positively and with confidence, in a calm and matter of fact way, for example, “this is your small ear, this is your big ear”, “your special ear”
- use age appropriate language
- keep it simple but use the medical name for the condition
- use descriptive and factual language (colour, shape, size etc.)
- be consistent with the words used
- feel comfortable with the words used
Dealing with other peoples reactions
Other people’s reactions are greatly influenced by the way we present ourselves, and families and teachers can help children and young people develop their social skills by encouraging them to have good eye contact, positive body language, and to join in conversations and ask questions. Sometimes people ask unwanted questions about visible difference which brings unwanted attention. It can be helpful to think about who they are when deciding how to respond:
- People you will never see again (strangers)
- You don’t have to make it okay for them
- It doesn’t matter so much what is said to them
- People you will see sometimes
- You might want to say a little bit
- People you will see a lot e.g. work colleagues, parents at your child’s school
- It can be helpful to invest time in addressing the issue positively
A really useful strategy is:
EXPLAIN
REASSURE
DISTRACT
An example of this is:
- “That’s just my small ear, I was born this way” (explain)
- “It doesn’t hurt” (reassure)
- “Are you going to football after school?” (distract)
It is important to remember that not everyone who stares is being rude. Often people are curious if it’s something they haven’t seen before, or they may even be daydreaming. If your child or you feel uncomfortable you/they can say:
- “Can we talk about something else? I’ve already had lots of questions today.”
- “Please don’t stare. I would prefer you to say hello or ask a question if you are curious.”
- “Sorry I am busy / in a rush”
Siblings
Sometimes, it can be hard for brothers and sisters of the child with Microtia or visible difference. They may feel protective of their sibling, notice or resent the interest and attention that their brother or sister’s visible difference attracts, be aware of stares or comments made and may get asked questions, be teased about their brother’s or sister’s condition or appearance. If you notice this happening, you can encourage them to use the strategies mentioned above.
It can be really helpful for children and young people with Microtia (or any visible difference) to meet other young people with similar conditions, to share their experiences and normalise their feelings. This is something we can potentially help facilitate, or can be arranged through the Microtia UK charity.
