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Guide to Early Surgical Management of Lip Hemangiomas Based on Our Experience of 214 Cases

Li, Wai-Yee M.D., Ph.D.; Chaudhry, Obaid M.B., B.Ch., B.A.O.; Reinisch, John F. M.D.

Plastic and Reconstructive Surgery: November 2011 - Volume 128 - Issue 5 - p 1117–1124
doi: 10.1097/PRS.0b013e31822b6908
Pediatric/Craniofacial: Original Article

Background: Hemangiomas are the most common vascular lesions in infancy. The majority of hemangiomas occur on the face and cause significant parental distress because of their high visibility. Traditionally, they have been managed by a “watch and wait” approach due to their known propensity to improve significantly over time. This is a particularly difficult approach for hemangiomas of the lips due to their high visibility and their tendency to leave residual deformity even after resolution.

Methods: The authors performed a retrospective chart review of pediatric patients who underwent surgical excision of upper and lower lip hemangiomas at Children's Hospital Los Angeles between 1992 and 2006.

Results: The authors identified 214 patients with an average age of 23.6 months at the time of surgery. All patients had improvements in lip appearance, with minimal complications. No transfusions were required, and all but two patients (lip switch flaps for major tissue loss) were managed on an outpatient basis. Overall, complications were minimal, with a high degree of parent satisfaction.

Conclusion: The authors conclude that many children would benefit from early excision and present guidelines for the early surgical management of lip hemangiomas.

Los Angeles, Calif.; Dublin, Ireland; and Beverly Hills, Calif.

From the Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California; Royal College of Surgeons in Ireland; and Cedars-Sinai Medical Center.

Received for publication October 16, 2010; accepted February 28, 2011.

Disclosure: There are no commercial associations or financial disclosures that might pose or create a conflict of interest with information presented in this article. No outside funding was received.

John F. Reinisch, M.D.; Craniofacial and Pediatric Plastic Surgery, Cedars-Sinai Medical Center, 250 South Robertson Boulevard, Suite 506, Beverly Hills, Calif. 90211,

©2011American Society of Plastic Surgeons