23 - Pediatric Plastic Surgery

Abstract

The word “plastic” is derived from the Greek word for “moldable.” Therefore, plastic surgery refers to surgery that focuses on form and function. Form is often related to appearance, which is why aesthetics usually plays an important role in plastic surgery. Although all surgeons repair function to some degree, plastic surgery emphasizes functions that improve quality of life, such as eating, speaking, self-confidence, and social interactions. Patients with craniofacial anomalies, for example, may be able to eat and breathe, but because one of the main functions of the face is to look like a face, such individuals often suffer from significant isolation and social anxiety. Similarly, although speech is not essential for survival, a patient with a cleft-related speech dysfunction may have profound difficulty communicating with peers, which again can lead to isolation. Because many congenital deformities impact both function and appearance, problems encountered in pediatric plastic surgery can be distressing for patients and their families. The newborn’s anomalies are immediately apparent, causing emotions that range from guilt to fear. Many pediatric anomalies are associated with more extensive disorders or syndromes, making identification crucial for diagnosis and prognosis. Additionally, children are especially prone to trauma and other acquired abnormalities that require the surgeon to apply principles of reconstruction both for form and function, but also for growth. This chapter familiarizes the pediatrician or neonatologist with the most common pathologies of form and function that the pediatric plastic surgeon treats. It is important to educate parents that although improvements are the rule rather than the exception, the severity of the defect, variability in wound healing, and the growth of the patient make the final result difficult to predict.