Surgery for Hemangiomas


Earlier the general concept was to wait until the end of the involution phase and a surgical correction of the sequela (fibrofatty residuum, excess dyschromic tissue, sagging). Today, some surgeons recommend an early surgical intervention particularly in some cases. On the other hand, a majority of surgeons reserve this option for cases in which all other therapies have failed and the hemangioma still presents a risk to the patient.

Surgery is, in general, only considered during the involution phase, but in certain circumstances it does have a role in the late proliferation phase (e.g. large lip hemangioma that has not responded to steroids).

Surgery in early childhood should be considered in the following situations:

  • If it is obvious that resection is inevitable
  • If the scar would be the same length or appearance were excision to be postponed until late involution or involuted phase
  • If the scar can be easily concealed  
  • Nasal hemangioma (“cyrano” hemangioma)
  • Lip hemangioma (involuting/involuted) 
  • Eyelid hemangioma impairing the vision
  • Large forehead hemangioma
  • Pedunculated hemangiomas that bleed repeatedly
  • To excise the residual fibrofatty tissue (sequela of hemangioma) in the late involution phase.

Consideration should be given to the emerging facial image prior to school attendance.  



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