As the Medical Director of the Center of Craniofacial Disorders for Children’s Healthcare of Atlanta (CHOA), I have frequently performed maxillofacial surgery to correct the facial abnormalities that can occur in children as a result of either congenital defects or traumatic injury. While there are many different conditions that can be addressed with reconstructive plastic surgery procedures, one that we have had a great deal of success treating in children is a form of birthmark called a hemangioma.
Newborns often have temporary marks or blotches on the skin called birthmarks. While these are mostly harmless and often fade or shrink on their own over time, some can be far more disfiguring and even potentially debilitating. Hemangiomas, specifically, are a vascular type of birth mark that can appear either on or deep underneath the skin’s surface. Surface hemangiomas appear as bright red “strawberry marks” while those under the surface may have a blueish appearance, as they involve blood vessels in the deeper layers of skin. In many cases, small hemangiomas spontaneously shrink and disappear by the time a child is 5 to 9 years old, but larger ones may leave a scar as they regress while others, particularly those that appear on the face or neck, may be large enough to interfere with vision or block the nose or mouth. In these cases, prompt treatment is necessary in order to remove the obstruction and minimize long-term appearance deficits.
My colleagues and I have conducted several long term birthmark treatment studies(1,2) involving the use of intralesional laser treatments to reduce the size of capillary hemangiomas. While the use of external laser light, applied to the surface of the mark to shrink the blood vessels supplying blood to the area, has been used effectively for years, its limited ability to penetrate deep beneath the skin restricts its usefulness in cases where there is a deeper cavernous component or a completely subcutaneous lesion. By using a form of fiber-optic technology to introduce the laser energy to deeper levels of the skin, we have been able to consistently affect significant reductions in both the diameter and thickness of the lesions with an extremely small incidence of post-treatment complications. In particularly severe cases, where laser treatment has either proven ineffective or is not a viable option, surgical excision may be necessary to remove either the lesion or the scars that may result from it. Scar revision or autologous fat transfer techniques can also be used to rebuild the area and help achieve a more aesthetically pleasing appearance.
For more than twenty-five years, I have worked to offer the ultimate in pediatric surgical care to make both parents and children comfortable before, during, and long after their reconstructive surgery procedure. If you are interested in learning more about the pediatric reconstructive surgical procedures that I perform, I would welcome you to contact my office and schedule a consultation. Don’t forget to connect with me, Dr. Fernando Burstein, on Facebook, Twitter, and Google+ for the latest facial plastic surgery news.
- Burstein, FD., Simms, CA., Cohen, SR., Williams, JK., Pascal, M.: Intralesional Laser Therapy of Extensive Hemangiomas in 100 Consecutive Patients. Annals of Plastic Surgery. 2000 Feb;44(2);188-94.
- Burstein, FD.: Cartilage-Sparing Complete Otoplasty Technique: A Ten Year Experience with 100 Patients. Journal of Craniofacial Surgery. 2003 Jul;14(4):521-5.