Surgery

This, along with lasers, is the option that has changed the results we can obtain most dramatically.

Goals of Surgery

We can operate on lesions throughout proliferation or involution. The exact timing is influenced by the child’s age and weight as well as the impact the hemangioma is having on function.

The main goals of surgery:

• Remove the lesion completely
• Set the stage for other treatments;
• Correct what is left after involution.

For example, a rapidly proliferating compound hemangioma of the upper eyelid that is beginning to impair vision may be removed at an earlier point than a deep hemangioma of the back which has begun to involute.

Surgeries may be done in stages in certain cases in order to get the best cosmetic result. Scar revisions, in particular, need to be done judiciously in young patients.

The combination of all the above modalities is very commonly used. We may treat the superficial component of a compound hemangioma of the nasal tip with the PDL in preparation for surgery of the deep component. Or we may treat a deep hemangioma of the orbit that is pushing on the eyeball with steroids at the same time we use the PDL for a separate superficial lesion in the same patient. The bottom line is there are options.

Avoid Misconceptions about Surgery

There are a lot of misconceptions about operating on hemangiomas – the risk of hemorrhage in particular – that we are trying to educate physicians about.

Unfortunately, there are some physicians who on TV and in lectures scare families into thinking that only a handful of surgeons are capable of doing these surgeries. The reality is that the reason there aren’t that many of us doing this kind of work is because doctors haven’t yet learned. This Foundation is committed to training other doctors to successfully operate on these lesions so families don’t have to travel such great distances for treatment. In general, children can be operated on very successfully with a minimal amount of blood loss.