Pediatric plastic surgery

Pediatric plastic surgery is plastic surgery performed on children. Its procedures are most often conducted for reconstructive or cosmetic purposes. In children, this line is often blurred, as many congenital deformities impair physical function as well as aesthetics.

Surgery is defined as treating injuries or conditions with operative instrumental treatment. Plastic is a derivative of the Greek word plastikos, which means "to build up" or "to take form". This is a logical prefix, as parts of the body are remade or reformed during most reconstructive and cosmetic surgical procedures. Children make up roughly 3% of all plastic surgery procedures, and the majority of these procedures correct a congenital deformity.[1]

Reconstructive plastic surgery is performed on abnormal structures of the body that are the result of congenital defects, developmental abnormalities, trauma, infection, tumors or disease. While reconstructive surgery is most often undertaken to regain normal motor function or prevent current or future health problems, aesthetics is also considered by the surgical team.[2]

Cosmetic plastic surgery is defined as a surgical procedure undertaken to improve the physical appearance and self-esteem of a patient. These procedures are usually elective.

Reconstructive Plastic Surgery

Several of the most common congenital birth defects can be treated by a plastic surgeon operating as an individual, or as a part of a multi-disciplinary team. The most common pediatric birth defects requiring plastic surgeon involvement include:

Cosmetic Plastic Surgery

While the majority of pediatric plastic surgery procedures done are reconstructive; there are those performed for cosmetic purposes. The most common procedures done for cosmetic benefit in children include:

Out of all procedures, nose reshaping generally has the most cases on an annual basis (4,313 procedures in 1996). However, children make up only 9% of the total caseload for all nose reshaping. On the opposite end of the spectrum, children requiring ear surgery accounted for 2,470 procedures in 1996, a total of 34% of all total ear surgeries. While many of these procedures are done for purely cosmetic benefit, many plastic surgeons work on these features (giving them a more normal appearance), while performing a surgery to improve function as the result of a congenital deformity.[8]

Multi-Disciplinary Emphasis

With the unique challenges created in the field of plastic surgery, an increasingly popular trend has been to utilize the multi-disciplinary team approach in treatment.

Common conditions involving team treatment include:

Children’s Hospitals with Dedicated Plastic Surgery Departments

With the advent of pediatric plastic surgery as a legitimate subspecialty, many children’s hospitals have begun to add comprehensive Plastic Surgery Departments to their hospitals programs. Such programs include:

Children's Hospital Los Angeles - Division Head: Mark Urata, DDS, MD

Children's Hospital Boston – Plastic Surgeon-in-Chief: John G. Meara, MD, DMD, MBA, FACS, FRACS

Children's Hospital of Philadelphia – Director: Scott P. Bartlett, MD

Texas Children’s Hospital, Houston – Chief of Service: Samuel Stal, MD

Children's Hospital Colorado - Department Chief: Frederic Deleyiannis, MD, MPhil, MPH, FACS

St. Louis Children's Hospital

In addition to those offering comprehensive departments, many other pediatric hospitals also treat plastic surgery cases within the department of surgery.

References

  1. Stephen Juan. National Post. “No Plastic in Plastic Surgery: Mysteries of our Weird and Wonderful Bodies Explained.” October 2005, p.A17. Accessed October 17, 2007. <http://0-www.lexisnexis.com.library.stonehill.edu/us/lnacademic/results/docview/docview.do?risb=21_T2284942154&format=GNBFI&sort=RELEVANCE&startDocNo=1&resultsUrlKey=29_T2284942163&cisb=22_T2284942162&treeMax=true&treeWidth=0&csi=10882&docNo=3> accessed at Lexis Nexis Academic.
  2. "What is the difference between cosmetic and reconstructive surgery?". The American Society of Plastic Surgeons. 2007. Retrieved 2007-10-17.
  3. "Birth Defects: Frequently Asked Questions (FAQs)". National Center on Birth Defects and Developmental Disabilities. July 18, 2007. Retrieved 2007-11-07.
  4. E Gene Deune, MD. (Aug 6, 2007). "Syndactyly". WebMD. Retrieved 2007-11-07.
  5. Alan Greene (May 19, 1997). "What is polydactyly". DrGreene.com. Retrieved 2007-11-07.
  6. Biggs WS (2003). "Diagnosis and management of positional head deformity". American Family Physician 67 (9): 1953–6. PMID 12751657.
  7. Kabbani H, Raghuveer TS (2004). "Craniosynostosis". American Family Physician 69 (12): 2863–70. PMID 15222651.
  8. Kagan, Jerome; Gall, Susan B. (1998). The Gale encyclopedia of childhood & adolescence. Detroit: Gale. pp. Plastic Surgery. doi:10.1223/0810398842. ISBN 0-8103-9884-2.
  9. "Finding Solutions to Adolescent Breast Problems.". Children’s Hospital Boston. August 2007. Retrieved 2007-11-07.
  10. "Cleft Lip and Palate Program". Children’s Hospital Boston. Retrieved 2007-11-07.
  11. "Craniofacial Anomalies Program". Children’s Hospital Boston. Retrieved 2007-11-07.
  12. "Vascular Anomalies Center". Children’s Hospital Boston. Retrieved 2007-11-07.
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