Pediatric Plastic and Reconstructive Surgery

We treat a range of vascular anomalies and malformations including the following:

• Venous malformations — These are bluish lesions that are caused by abnormally shaped veins. They can be small or large and will get bigger as a child grows, most notably during puberty. Venous malformations can also cause pain. They do not go away and often recur after treatment.
• Lymphatic malformations — This sponge-like collection of abnormal lymphatic channels contains clear fluid or blood and can rapidly enlarge. Lymphatic malformations can occur anywhere in the body but most often appear in the head and neck. They are related to other conditions, including:
  • Gorham-Stout disease — a type of lymphatic malformation that occurs in bones and partially destroys them
  • Milroy disease — an inherited lymphedema, present at birth and commonly occurring in the legs
  • Angiokeratoma — a group of skin lesions that are raised, dark red to black in color, and about 1 to 10 millimeters in size. Because these lesions often bleed spontaneously or following an abrasion, treatment may be required to control bleeding.
• Arteriovenous malformations (AVM) — These are abnormal connections between arteries and veins. They are commonly seen on the head and neck and often appear as light stains at birth. Other AVMs occur on the trunk or a limb but may not be visible until later in childhood. AVMs may also occur in the skin, fat, muscles and organs such as the brain, lung, liver and intestines.

Our pediatric plastic and reconstructive surgery team and pediatric dermatology team provide evaluation, monitoring and care for a variety of pediatric vascular tumors that occur in children, including the following:

• Infantile hemangiomas — Abnormal clusters of small blood vessels on or under a baby’s skin, these appear 1 to 3 weeks after birth. They brighten in color and increase in size during the first 2-4 months of life and then typically start to fade and shrink. Most do not cause complications and go away without treatment.
• Congenital hemangiomas — This type of vascular lesion is present and fully grown at birth.
• Tufted angioma — A noncancerous tumor of the blood vessels, this appears most often during infancy or early childhood.
• Birthmarks — A colored mark on or under the skin, these can be present at birth or shortly after. They can be large or small and are most often harmless.
• Pyogenic granulomas — These are red, rapid-growing lesions that bleed easily. They most often occur after an injury and are noncancerous.
• Hemangioendotheliomas — Rare, cancerous tumors that affect the epithelial cells that line the inside of blood vessels, these tumors most commonly affect the liver, lungs, bones and soft tissues.
• Angiosarcoma — This type of cancer occurs in the lining of blood and lymph vessels.
• PTEN hamartoma — This includes a group of disorders characterized by multiple noncancerous growths in different areas of the body.

Our specialized physician team also provides evaluation, diagnosis, monitoring and treatment of concerning moles, including the following:

• Spitz nevus — This is a rare type of skin mole in children that resembles melanoma in appearance but is noncancerous.
• Nevus sebaceous — Also rare, this benign birthmark is technically classified as a hair follicle tumor and is typically found on the scalp, face or neck. It is made of extra oil glands in the skin.
• Nevus of Ota/Ito — This is a condition where hyperpigmentation (darkening) occurs around the eye (Ota) or on the shoulder and side of the neck (Ito).