Pediatric Plastic Surgery

 

Pediatric Plastic Surgery

The field of pediatric plastic surgery deals with reconstructing a variety of congenital and acquired defects among children.We treat birth defects that can be reconstructed by the doctors:

  • large congenital nevi
  • cleft lips and palates
  • premature closure of skull plates resulting in malformations of the skull
  • various types of congenital growths, such as hemangioma and vascular defects (those originating in the blood vessels)
  • congenital missing ear rim, and more.

The acquired defects the doctors can reconstruct are mostly the result of prior injury and burns. By and large, treatment of the defects mentioned above entails complex surgical procedures, which combine knowledge and expertise of different surgical techniques, such as microsurgery, stretching adjacent tissues to reconstruct missing or damaged tissue, rebuilding bone by stretching adjacent bone, transplanting cartilage and bone, and many others.

    • Large congenital nevi. An interesting and innovative method enables us to stretch or expand existing skin and gain healthy tissue to help reconstruct extensive areas of skin damaged from burns or tumors. Using this method, a balloon is inserted under the skin and gradually inflated using a saline solution. The gradual inflation “grows” healthy skin that can be used for reconstructing extensive areas. This method is particularly effective for scalp reconstruction.
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    • Cleft lips and palates. One of the more common defects seen by the multidisciplinary teams is the cleft lip and palate. Even when the child is a fetus still in utero and the defect is observed through an ultrasound examination, the teams counsel the parents regarding the impact and influence the defect could have on their child’s life. After birth, the newborn is given a comprehensive examination and a treatment plan is devised. The orthodontic team prepares the child for surgical intervention before his first birthday. Repair of the cleft lip is carried out at age two months, and at the same time preliminary repairs are done to the nose. The cleft palate is repaired at the age of about 10 months. In the future the child may need additional surgical procedures, such as a bone transplant for the dental ridge, additional surgery on the nose and septum, etc. The children are monitored by the team until they reach adolescence.

 

    • Premature closure of skull plates Another common defect treated by the team is premature closure of the fontanelles (or “soft spots”) in the newborn, resulting in a malformed skull. Such children often need extensive surgery during their first year of life, which is aimed at enabling symmetrical and unimpaired growth of cranial and facial bones. Recently we have witnessed more and more cases of a flattening of the rear of the skull that is not the result of a premature closure but rather is due to external pressure while in the uterus or after birth. Such flattening responds to non-surgical techniques, such as physiotherapy or a cranial shaping helmet.
  • Congenital missing ear rim. Great strides have been made in recent years with regard to otoplasty reconstructive surgery for children born without an outer ear rim. Using a method that was developed during the past decade, the ear rim is reconstructed using cartilage taken from the patient’s rib during two surgical procedures. Later on, a team from the otolaryngology surgery department improve hearing in the reconstructed ear. Otoplasty reconstructive surgery is performed at about age 6, before the child enters school.
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