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Plastic surgery isn’t only skin deep. For many, plastic surgery helps restore critical functions after injury or disease. In children, plastic and reconstructive surgeons treat congenital anomalies — that is, those present since birth — as well as acquired functional and appearance-related problems.

The goal of pediatric plastic surgery is to improve appearance, form, and function. The journey may feel scary, but you’ll have a team of compassionate professionals, with expertise in treating children, in your corner. If your child could benefit from plastic or reconstructive surgery, here’s what you need to know.

Types of Pediatric Plastic Surgery

There are many reasons a child may need plastic and reconstructive surgery.

• Congenital anomalies, which are deformities one is born with. These include cleft lip, cleft palate, and craniosynostosis, birthmarks, hand differences, and vascular anomalies.
• Traumatic injuries from dog bites, motor vehicle accidents, and household mishaps.
• Acquired problems that occur after birth but while children are still growing. These issues occur because of certain conditions, diseases, or injuries.

“The focus is to help patients feel whole,” says Jesse Goldstein, MD, director of UPMC Children’s Hospital of Pittsburgh‘s Cleft and Craniofacial Center. Making a child feel whole includes improving both function and appearance.

Who Is a Candidate for Pediatric Plastic Surgery?

Those receiving pediatric plastic surgery range in age from infancy to adulthood.

Dr. Goldstein says he has seen people as old as 60 come through the pediatric program to address chronic conditions that were treated in childhood.

Common conditions treated by pediatric plastic surgeons include:

• Birthmarks.
• Cleft lip and palate.
• Craniosynostosis.
• Dog bites.
• Ear anomalies.
• Facial trauma.
• Functional or appearance-related problems caused by trauma, disease, or surgery.
• Hand anomalies.
• Hand and extremity injuries.
• Vascular anomalies.

Some conditions need more than one procedure. Dr. Goldstein says these are often staggered to reduce physical and mental scarring.

“We don’t do them all at one time. We stage them [mostly because we want] to let the patient grow without scar[ring] and without repeated surgeries early on in life.”

Specialized Care for Each Child

Primary care doctors often refer children to a pediatric plastic surgeon. The surgeon then assembles a team of experts who will help care for the child and contribute to a care plan.

This larger team may include pediatricians, speech therapists, psychologists, dentists, orthodontists, and ear, nose, and throat specialists. Together, this team will build a personalized care plan for the child. Every child is unique, and so is the treatment they receive.

The surgery itself is only part of the plan. Pre- and post-surgery treatment plans include care from specialists focused on recovery and achieving the best results.

Dr. Goldstein says the care team puts a lot of emphasis on how to improve and restore function. For example, one goal of treating cleft lip and palate is to improve speech. This means not only fixing the cleft lip and palate surgically but also engaging the help of highly trained speech therapists.

As part of this approach, Dr. Goldstein asks this question about every patient: “How do we reconstruct the patient, make them feel whole and normal, and help them integrate well with their peers?”

Professionals in Pediatric Care

Every professional a child interacts with has special training in pediatric medicine within their field. Along with the surgeon, the nursing staff and anesthesiologist also specialize in pediatric care.

Pediatric plastic surgeons are not only specialized in pediatrics, they also devote 50% or more of their time to pediatric care.

Treatments for young patients differ from those of adults. That’s why having a care team specialized in pediatrics is important. The right plan allows children to continue to develop while maintaining function and minimizing scarring.

Pediatric plastic surgery facilities create an environment where children can feel safe. This includes options for open CT scans, as well as options for play during exams.

The Pediatric Plastic Surgery Journey

Beginning the journey of plastic surgery can be a scary time for families.

“Parents may think that [their child will never] be able to have a normal childhood or a normal development,” says Dr. Goldstein.

While the fear of the unknown is common, the results can change your child’s life.

“We will often get feedback and immense gratitude from parents and from patients alike, because now [the child] can walk down the street feeling whole. [They don’t feel] like they’re [being] looked at for any reason — other than maybe [someone likes] the sweater they’re wearing,” he says.

As a result, children can feel comfortable and confident socializing, going to school, playing sports, and working — just like their peers.

Pediatric Plastic Surgery Experts At UPMC Children’s

UPMC Children’s Hospital of Pittsburgh is a leader in the field of pediatric plastic surgery. UPMC is internationally renowned for using cutting-edge techniques and research to advance the field of pediatric plastic surgery.

“Sometimes, it’s surprising to our patients that such amazing talent is located right in their backyard,” says Dr. Goldstein.

UPMC pediatric specialists have experience in treating many medical conditions. We offer specialized care in craniofacial surgery, as well as in reconstructive surgery of the extremities.

Visit our website to learn more about the services offered by the Division of Pediatric Plastic Surgery at UPMC Children’s.

Editor's Note: This article was originally published on May 18, 2023, and was last reviewed on July 12, 2023.