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It's Not All Cosmetic: Pediatric Plastic Surgery for Congenital ...
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Children's plastic surgery is a plastic surgery performed on children. The procedure is most often done for reconstruction or cosmetic purposes. In children, this line is often blurred, as many congenital defects impair physical function as well as aesthetics.

Surgery is defined as treating an injury or condition with operative instrumental treatment. Plastics are derivatives of the Greek word plastikos , which means "build" or "take shape". This is a logical prefix, since body parts are regenerated or reformed during most reconstructive and cosmetic surgical procedures. Children make up about 3% of all plastic surgery procedures, and most of these procedures improve congenital defects.

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

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


Video Pediatric plastic surgery



Plastic Reconstruction Surgery

Some of the most common congenital birth defects can be treated by plastic surgeons who operate as individuals, or as part of a multi-disciplinary team. The most common childbirth defects requiring plastic surgeon involvement include:

  • Cleft lip and/or palate - A baby born with a defect will open around the upper lip. The size of the openings reaches anywhere from a small notch to a close to the base of the nostril, where it will involve one or both sides of the lips. Worldwide, the gap is estimated to affect 1 in every 700-1000 live births. Approximately 25% of cases of cleft lip and palate are inherited from the elderly, with another 75% believed to be the cause of a combination of lifestyle and opportunity factors.
  • Syndactyly/Polydactyly - The most common of congenital malformations affecting limbs. It is believed that Syndactyly, denotes variation, in which numbers can coalesce either partially or completely long, or as simply as superficially connected by the skin. It affects 1 in every 2,000 - 3,000 live births. Polydactyly is the presence of extra fingers or toes at birth, and is believed to affect somewhere around 2 out of every 1,000 live births. However, it is believed that many cases are so small that they are treated immediately after birth and not reported, so the actual statistics may be higher.
  • Plagiocephaly Position - In 1992, to reduce the incidence of SIDS, the American Academy of Pediatrics initiated the "Back to Sleep" campaign, which recommended that babies be put to sleep on their backs. While this is nearly half the number of SIDS deaths, the campaign also appears to help increase the incidence of plagiocephaly fivefold, roughly one in sixty live births. Plagiocephaly is just the alignment of one area of ​​the skull, generally one infant tends to like when they lie. While treatment is often as simple as repositioning a baby during sleep, in more obvious cases, helmet therapy may be used. In most cases, plagiocephaly is small enough and easily resolved, with many pediatric plastic surgeons becoming familiar with helmet therapy for more advanced cases.
  • Craniosynostosis - Less common, but potentially much more serious than plagiocephaly is craniosynostosis. Craniosynostosis is a congenital disorder originating from the central nervous system where one or more of the fibrous joints in the skull closes prematurely. This fusion often requires surgical intervention to reconstruct the skull (see craniofacial surgery) either to bring it back to its normal position or provide a more natural form. It is believed that craniosynostosis occurs in 1 of 1,800 to 2,200 live births, and is often a side effect of the associated syndrome.

Maps Pediatric plastic surgery



Cosmetic Plastic Surgery

While most of the pediatric plastic surgery procedures performed are reconstructive; something is done for beauty purposes. The most common procedures for cosmetic benefits in children include:

  • Breast Enlargement
  • Male Breast Reduction
  • Ear Surgery as a result of microtia
  • Rhinoplasty

Of all the procedures, nasal formation generally has the most cases each year (4,313 procedures in 1996). However, children account for only 9% of the total case load for all nose reshaping. At the end of the spectrum, children who require ear surgery accounted for 2,470 procedures in 1996, a total of 34% of total ear surgery. While many of these procedures are performed for pure cosmetic benefits, many plastic surgeons work on this feature (giving them a more normal appearance), while performing surgery to improve function as a result of congenital defects.

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Multi-Disciplinary Emphasis

With the unique challenges created in the field of plastic surgery, an increasingly popular trend is to utilize a multidisciplinary team approach in care.

Common conditions involving team care include:

  • Breast problems - Includes gynecomastia (male breast development), macromastia (too large breasts), tuberous defects, and breast asymmetry. Often, not only children with breast conditions suffer from physical problems, but also psychological side effects. With this knowledge, current multi-disciplinary clinics have emerged including specialists from plastic surgery, nutrition, adolescent medicine, psychology, gynecology, and social work.
  • Head, Neck, and Skull Tone - Includes angiofibroma, desmoid tumor, fibrosarcomas, hemangioma, lymphoma and lymphatic malformations, and neuroblastoma. While most procedures may be assigned to neurosurgeon, otolaryngology, and maxillofacial surgery, a multidisciplinary approach is also important to minimize scars and maintain somewhat normal shape and function.
  • Cleft lip and palate - In the case of cleft lip and palate, not only are there physical side effects manifested beneath the developed lips and palate, there are also a number of other potential complications. For this reason, CLP children are treated by teams that may include plastic surgeons or oral and maxillofacial surgeons, speech pathologists, audiologists, densites, orthodontists, and genetic professionals if there is a related syndrome.
  • Craniofacial Anomalies - Includes craniosynostosis, plagiocephaly, and syndromes associated with this defect. In the case of craniosynostosis in which surgical intervention is necessary, the involvement of a multi-disciplinary professional team is essential. Team members often come from the departments of plastic surgery, oral and maxillofacial surgery, neurosurgery, audiology, dentistry, orthodontics, and speech and language pathology. These professionals often assist not only in operational procedures, but in developing coordinated care plans for children throughout their lives.
  • vascular anomalies - vascular malformations, hemangiomas, and rare vascular tumors. Not only does the vascular anomaly have a prominent interior body effect; they manifest themselves physically as well. For this reason, the involvement of different specializations in care coordination is of the utmost importance. Specialists involved in vascular anomalies and hemangioma treatments often come from general surgical disciplines, vascular anomaly research, plastic surgery, dermatology, cardiology, haematology/oncology, neurology/neurosurgery, maxillofacial surgery, and otolaryngology. Children need treatment not only to minimize the physical side effects of hemangiomas or vascular anomalies, but also help figure out why tumors are present (if in fact tumors), and develop treatment if needed.

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References

Source of the article : Wikipedia

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