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Kochi

The why, when and where of plastic surgery for children 

An overview of plastic surgeries some children may require to improve certain functions 

Dr Aadithya Rangarajan

KOCHI: Plastic Surgery as a speciality in India is relatively young. Unlike developed countries, there are very few centres in our country where there is a dedicated team for the treatment of children with anomalies. Pediatric plastic surgery is a subspeciality of Plastic Surgery that aims to improve the quality of life of children with certain anomalies. It helps in restoring function and improves appearance.

It involves different areas such as surgery for cleft (split lips), facial differences, malformed ears (microtia), misshaped head (craniosynostosis) and traumatic facial injuries (lacerations, fractures). Pediatric hand surgery is another area which takes care of anomalies such as fused fingers (syndactyly), multiple fingers (polydactyly), upper limb deformities and those following trauma, infection, and tumours.

Then, there is microvascular surgery to repair blood vessels-and nerves in replantation of fingers and extremities, wound coverage, and brachial plexus (birth palsy). For treatment of birth moles, cysts, burns, complex wounds, vascular anomalies, etc, general pediatric plastic surgery is required. And for improved appearance and reconstruction of the nose (rhinoplasty), ears (otoplasty), breast (in adolescents with absent breasts), and scar revisions, aesthetic pediatric plastic surgery is required. 

Children with deformities often have a hard time growing up as society looks at them differently. Now with the advancement in surgical techniques, technologies offer children a normal childhood without the fear of being judged. To reduce the psychological impact on children, many conditions with abnormal appearances can be treated in the preschool age itself.

Also, children need sensitive care while treating their anomalies. A child-friendly environment reduces the pain and anxiety of both parents and their kids. It also gives them the courage to return to the hospital to undergo multiple surgeries.

There is a quote from the book ‘Surgeon and the Child’ by Willis Potts dedicated to an infant born with a serious deformity. “If this infant could speak, it would beg imploringly of the surgeon, please exercise the greatest gentleness with my miniature tissues and try to correct the deformity at the first operation.

Give me blood and the proper amount of fluid and electrolytes, and plenty of oxygen for the anaesthesia, and I will show that I can tolerate a terrific amount of surgery. You will be surprised at the speed of my recovery and I shall always be grateful to you.”

A pediatric plastic surgeon is an integral part of a multidisciplinary team and contributes immensely to a child’s life from birth through young adulthood.

Mind and body 
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The writer is a consultant plastic surgeon at Medical Trust Hospital

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