Frequent pathologies treated by Plastic Surgery in children and adolescents

What pathology is usually treated by Plastic Surgery in children?

It is difficult for us to understand the association between plastic surgery, with its most popularized connotation, which is cosmetic surgery, and children. Children’s plastic surgery is a medical superspecialty in charge of correcting congenital or acquired defects during childhood and adolescence, avoiding the functional or psychological sequelae of not having corrected a problem in time.

The most frequent pathologies are:

  1. Auricular deformities: protruding ears are a very frequent cause of psychosocial discomfort in children. From the age of 6-7 years surgery may be indicated if the child demands it. But even in the first weeks of life, without the need for surgical treatment, we can solve some of these cases definitively.
  2. Cleft lip and palate: this problem is the most common congenital facial malformation and one of the most exciting challenges for the plastic surgeon. The treatment of these children requires the attention of a medical team trained and familiar with its management.
  3. Surgery in the adolescent: There are many disorders that begin to manifest with pubertal changes, such as thoracic or breast pathology. In addition, the relationship between surgeon and patient in this age group takes on special relevance because the young person must be able to confidently convey his or her expectations and assume his or her share of responsibility in the process.
  4. Congenital nevus: not all moles require surgical treatment. But in the event that the patient is not comfortable with it, or in selected cases where the presence of the mole may pose a risk, it is preferable that surgery is performed by a specialist.
  5. Scars: Accidents are inevitable, but their sequelae are often concealable.
  6. Poland syndrome: This is a little known entity, which requires a long follow-up of the child until the end of its development. In it, we can find alterations of the chest, hand or ribs and specialists must know when is the optimal time for each surgery.
  7. Disorders in the child: cysts, braces, skin tumors… And a long etcetera of disorders that, due to their location, we want to reach the hands of a surgeon who pays special attention to detail.
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When is it necessary to see a pediatric plastic surgeon?

At the moment of birth, the pediatrician will be the one who considers that the child can benefit from a consultation with the specialist. In these cases, my recommendation would be that the referral be made as early as possible to provide the necessary information to the family of the requirements and the optimal time of treatment of their child. Fortunately, in most cases, the pathology will be benign and not urgent, but it is advisable to consult and be well informed.

Before starting primary school, around the age of 6, it is extremely rare for a child to show complexes or insecurities. But from that age, the child may already show a desire to correct defects with which he/she does not feel comfortable. Not all cases will require surgical treatment, but providing information to parents and patients allows the child to develop much more self-confidence.

Adolescence is a crucial stage in the social development of the individual and also a time when extreme importance is given to their image. Being self-confident and satisfied with one’s appearance conditions the psychological well-being of the young person.

Are measures taken so that the child’s experience in the operating room is not traumatic?

Of course. In many cases it will depend on the age of the child and his or her capacity for understanding. But, as a rule, children are not subjected to any “aggression” while awake. They will be sedated by inhalation beforehand and will not be aware of any manipulation that might be painful for them.

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The atmosphere in the operating room is calm and relaxed, with the mother/father’s company until the last moment and, as soon as the child wakes up, he/she is again accompanied by his/her family so that he/she does not feel abandoned.

The child is accompanied at all times by staff accustomed to working with this group of patients.

What is the follow-up of a child who has undergone plastic surgery?

The care of the child will always be carried out by the same specialist so that the child feels confident and secure. At no time is deception or “forced” actions carried out. We believe that the child’s trust in the doctor is important and, from a very young age, they are able to understand and collaborate in the process they are going through. Children who understand, collaborate. That is why it is important to explain and involve them in the process.

After any intervention, the postoperative follow-up will be carried out in the consultation room, as required in each case. Usually, one or two dressings are enough to evaluate the result and remove the suture material. Subsequently, the surgeon will indicate the need for successive revisions until definitive discharge.