Paediatric Plastic Surgery: Treating Children with Specialised Care

Plastic surgery in children requires a fundamentally different approach compared to adults. Children are not simply small adults; their anatomy, physiology, and psychology demand specialised knowledge, gentle handling, and age-appropriate care. Dr. Prasanna Somvanshi, a fellowship-trained plastic surgeon in Mumbai, has extensive experience in paediatric plastic surgery and practises at leading children's hospitals including NH SRCC and Surya Hospital, both of which are equipped with dedicated paediatric anaesthesia, intensive care, and nursing teams.

Common Paediatric Plastic Surgery Conditions

Cleft Lip and Palate

Cleft lip and palate is one of the most common congenital anomalies, affecting approximately 1 in 700 births in India. The condition occurs when the lip and/or palate do not fuse completely during fetal development, resulting in a gap that affects feeding, speech, hearing, and facial appearance. Dr. Prasanna Somvanshi, a Smile Train fellowship-trained surgeon, follows internationally recognised protocols for cleft care:

Cleft lip repair (cheiloplasty): Typically performed at around 3 to 6 months of age, this surgery restores the normal anatomy of the lip and nose
Cleft palate repair (palatoplasty): Performed at 9 to 12 months of age, before the child begins speaking, to close the palatal gap and enable normal speech development
Secondary procedures: Alveolar bone grafting, rhinoplasty, VPI surgery, and orthodontic treatment are performed at appropriate ages as part of the comprehensive cleft care pathway

Burn Injuries in Children

Burns are tragically common in Indian children, often caused by hot liquids, contact with stoves, or flame injuries. Paediatric burn management requires specialised care from the acute phase through long-term scar management and reconstruction. Dr. Somvanshi provides:

Acute burn care: Wound management, skin grafting, and prevention of infection
Burn scar contracture release: As children grow, burn scars can tighten and restrict movement, particularly around joints. Surgical release with skin grafting or flap coverage restores mobility
Scar management: Pressure garments, silicone therapy, and laser treatment to improve scar quality and appearance

Vascular Anomalies and Birthmarks

Haemangiomas and vascular malformations are common in children. While many haemangiomas resolve spontaneously, some require treatment due to their size, location, or associated complications. Dr. Prasanna Somvanshi evaluates each child individually and recommends treatment based on the type, location, and natural history of the lesion. Treatment options include medical therapy (propranolol for infantile haemangiomas), laser therapy, sclerotherapy, and surgical excision.

Hand and Limb Deformities

Congenital hand anomalies include conditions such as:

Syndactyly: Fusion of fingers or toes, requiring surgical separation and skin grafting
Polydactyly: Extra fingers or toes that may need surgical removal for functional and cosmetic reasons
Constriction band syndrome: Amniotic bands that wrap around developing limbs in utero can cause constrictions, requiring surgical release
Trigger thumb: A locked thumb in the flexed position, commonly noticed in toddlers, often requiring a minor surgical release

Ear Deformities

Prominent ears, accessory auricles (skin tags near the ear), and microtia (underdeveloped ear) are conditions that can be addressed in childhood. Otoplasty for prominent ears is typically performed after age 5, when the ear cartilage is sufficiently developed. Microtia reconstruction is a more complex undertaking, usually staged over multiple surgeries beginning around age 8 to 10.

Congenital Skin Lesions

Giant congenital melanocytic nevi (large dark birthmarks) and other skin lesions may require staged excision with tissue expansion to minimise scarring and achieve complete removal. Dr. Somvanshi plans these procedures carefully, considering the child's growth potential and the need for multiple stages.

The Child-Friendly Approach

Dr. Prasanna Somvanshi understands that hospitalisation and surgery can be frightening for children and their families. His approach emphasises:

Age-appropriate communication: Explaining procedures to children in simple, reassuring terms
Parental involvement: Keeping parents informed and involved in every step of the decision-making process
Minimising hospital stays: Performing day-care procedures whenever safely possible to reduce the disruption to the child's routine
Pain management: Using multimodal pain management protocols to ensure children are comfortable after surgery
Long-term follow-up: Monitoring the child's growth and development, with timely interventions as needed

Choosing the Right Hospital for Paediatric Surgery

The hospital environment plays a crucial role in paediatric surgical outcomes. Dr. Somvanshi's affiliations with NH SRCC and Surya Hospital provide access to dedicated paediatric operating theatres, child-sized equipment, experienced paediatric anaesthesiologists, and paediatric intensive care units. These facilities ensure the highest standards of safety for young patients. Additionally, his practice at SevenHills, HN Reliance, MRR Hospital, and Sushrusha Hospital allows him to offer paediatric consultations across Mumbai.

If your child has a condition that may benefit from plastic surgery, schedule a consultation with Dr. Prasanna Somvanshi. Early evaluation and timely intervention can make a significant difference in your child's development, function, and self-esteem. Contact our clinic today to book an appointment at NH SRCC, Surya Hospital, or any of our six Mumbai hospital locations.