Pediatric Plastic Surgery
UF surgeons offer a wide range of plastic and reconstructive surgical care for children of all of ages. Dr. Ashley Lentz completed additional fellowship training in the area of pediatric plastic surgery.
UF Craniofacial Center
Working as part of the University of Florida Craniofacial Center clinical team, care is offered for children with cleft lip and/or palate. One of the most commonly occurring congenital anomalies, affecting one in every 700 newborn babies, the causes of cleft lip/palate have yet to be completely determined. Children born with cleft and craniofacial deformities are evaluated, followed and treated by team members of the UF Craniofacial Center.
A cleft lip may be unilateral or bilateral. Surgical repair is generally performed at 10 to 12 weeks of age, although optimum timing of repairs may differ from child to child. The repair of the cleft lip is performed in the operating room under general anesthesia. The procedure includes reconstruction of the upper lip’s muscle structure and steps to improve the deformity of the nose. After surgery, absorbable sutures (stitches) remain in your child’s lip. These sutures usually do not require removal as the sutures degrade and the body absorbs them through the healing process. Silicone rubber tubes (stents) may be used in the nose to help correct a deformed nostril.
The usual hospital stay is one day. Following surgery the sutures should be cleaned frequently to prevent crust formation and infection. You may use a cotton-tipped applicator and half strength hydrogen peroxide. The surgeon may prescribe an ointment for you to put over the incision and sutures.
Repair of a cleft palate is usually performed at nine to twelve months of age. More than one operation may be necessary to close the cleft palate. The cleft palate operation is performed under general anesthesia in the operating room. At the University of Florida, most children will be treated with the Furlow Palatoplasty technique. The usual hospital stay after surgery is one to two days. Feeding is resumed postoperatively as soon as tolerated by the patient.
Pharyngoplasty is a surgical procedure that is sometimes required to treat hypernasal speech, either after cleft palate repair or for unrelated conditions. At UF several operations are used for treating hypernasality (velopharyngeal insufficiency). Patients are evaluated by members of the UF Craniofacial Center and a treatment plan is developed. Most patients who require surgery will be in the hospital two days after the procedure, which lasts about two hours. The postoperative considerations and care are much the same as for repair of the cleft palate.
Craniofacial anomalies include craniosynostosis (premature closure of the sutures in the skull) and other, rarer conditions. These are treated within the context of the UF Craniofacial Center, primarily by a pediatric neurosurgeon and a plastic surgeon.
Learn more about the UF Craniofacial Center at www.cleft.ufl.edu.
UF pediatric plastic surgeons also offer:
Otoplasty, also known as ear pinning, helps improve the shape, position and proportion of the ear. This surgery, which is typically an outpatient procedure, is performed to either correct deformities present since birth or correct the impacts of an injury.
Many otoplasty patients are children. Generally speaking, kids must be at least 5 years old and have stable enough ear cartilage to allow for correction. They also must be able to follow instructions well and not seem uncomfortable with the thought of surgery.
Some patients may require a second or third procedure to make updates and corrections to prior ear pinning surgeries.
Microtia, when the outer ear is underdeveloped, occurs in approximately one of every 7,000 to 8,000 births. It is uncertain why microtia occurs. It usually affects one ear, but may affect both ears. Microtia is often associated with other conditions or syndromes that disfigure the face or head. The middle ear, as well as the outer ear, is affected in microtia, and hearing is reduced in the microtic ear. A UF otolaryngologist will evaluate the hearing and middle ear status and advise treatment. Treatment for the external ear deformity is usually a staged process, conducted by a plastic surgeon in three or four operations. The patient’s own rib cartilage is used in the reconstruction. A second form of treatment is a prosthesis, or artificial ear, that is secured by an implantable device. Both options are used by University of Florida physicians.
Congenital melanocytic nevus
Congenital melanocytic nevi are known as “birthmarks.” These pigmented lesions tend to darken over time. They occur as a result of an embryologic abnormality in which a cluster of nevus cells maintain the melanin pigment. These lesions can range in size from very small to giant in which they cover the majority of the body. Special techniques are used to remove these lesions. Efforts are made to obtain optimal, realistic aesthetic outcomes. In many cases of large nevi, tissue expansion with a balloon is needed to recruit additional skin to cover the defect, once the nevus is removed.
Hemangiomas are a vascular, tumor-like malformation that has a deep red coloring. They appear at birth or in the first weeks of infancy, with the size of the growth peaking at one year of age. Hemangiomas can appear on any part of the body, including the head and neck. While benign, if it appears over the eye it can cause vision loss. After peaking in size, hemangiomas do tend to shrink down in size, however the discoloration remains. Treatments to reduce the size of the growth include medications, such as beta-blockers and steroids. For some patients laser therapy can help lighten the discoloration.
While some patients with hemangioma undergo conservative therapy, others may require surgical removal. Surgery is a well thought-out approach and each case is determined by the individual problem. The specifics of a surgery can be discussed with your surgeon.