Doing corrective or reconstructive plastic surgery for children and infants adds a new level of difficulty. Much is required of the surgeon and his team: Timing is often critical, a special knowledge of pediatrics is essential, the ability to do extremely delicate work is required and an understanding of emotional and social aspects is necessary. The legacy of Drs. Lehman and Tantri is decades of successful pediatric plastic surgery. It has been their most important work, and it is a labor of love that they continue today.
Pediatric surgery patients can have a variety of needs, but there are two basic categories: those who have congenital deformities, otherwise known as birth defects, and those with developmental deformities, resulting from accident, infection, disease, or in some cases, aging.
Typical examples of congenital abnormalities are birthmarks; cleft-lip and palate deformities; hand deformities such as syndactyly (webbed fingers), or extra or absent fingers; and abnormal breast development.
We always favor the most direct, least complex way of achieving the desired result. The size, nature and extent of the injury or deformity will determine what treatment option is chosen and how quickly the surgery will be performed. Reconstructive surgery frequently demands complex planning and may require a number of procedures done in stages.
Because it's not always possible to predict how growth will affect outcome, a growing child may have to plan for regular follow-up visits on a long-term basis to allow additional surgery as the child matures.
Only four conditions are discussed here, but we can provide in-depth information about many other situations. Please feel free to ask.
Cleft Lip and Palate
In the early weeks of fetal development, long before a child is born, the right and left sides of the lip and the roof of the mouth normally grow together. Occasionally, however, in about one of every 800 babies, those sections don't quite meet. A child born with a separation in the upper lip is said to have a cleft lip. A similar birth defect in the roof of the mouth, or palate, is called a cleft palate. Since the lip and the palate develop separately, it is possible for a child to have a cleft lip, a cleft palate, or both.
If your child was born with either or both of these conditions, your doctor will probably recommend surgery to repair it. Medical professionals have made great advances in treating children with clefts and can do a lot to help your child lead a normal, healthy, happy life.
A team approach. Children born with a cleft lip or palate may need the skills of several medical professionals. In addition to needing plastic surgery to repair the opening, these children may have problems with their feeding and their teeth, their hearing, their speech and their psychological development as they grow up.
For that reason, parents should seek the help of a Cleft Lip and Palate Team as early as possible, to plan for your child's care from birth, or even before. Typically, a Cleft Team might include a plastic surgeon, a pediatrician, a dentist, a speech and language specialist, a social worker, a hearing specialist, an ear-nose-throat specialist, a psychologist, a nurse, and a genetic counselor. With Dr. Lehman's long experience in cleft lip and palate surgery, he can advise you and help you develop a team of doctors right for your child.
Tumors, Anomalies and Abnormal Growths
When a child's tumor requires surgery, neurosurgeons, otolaryngologists, and maxillofacial surgeons may all be involved in a multidisciplinary approach, which is often crucial in order to minimize scars and maintain as much normalcy to shape and function as possible.
Craniofacial anomalies may occur in children, too. Craniosynostosis is an example. It occurs when some or all of a child's skull sutures (soft spots) close too early, causing problems with brain and skull growth. When surgical intervention is necessary, the involvement of a team of multi-disciplinary professionals is of utmost importance. Team members may come from plastic surgery, oral and maxillofacial surgery, neurosurgery, audiology, dentistry, orthodontics, and speech and language pathology. These professionals assist not only in surgical procedures, but also in developing coordinated care plans for the child throughout their life.
Another case that often requires a team approach occurs when a young child needs reconstructive otoplasty (outer-ear surgery) to correct overly-large or deformed ears.