This section of the forum is dedicated to discussions addressing linear scars, depressed scars, keloid scars, hypertrophic scars, and other facial reconstructive topics. (Of note, Dr. Lam no longer accepts medical insurance so he rarely manages cancer reconstruction or trauma anymore.)
My 10 year old daughter was bitten by a dog when she was 3. She sustained a large scar to her forehead and 2 smaller scars on the left side of her face of which you can still see the stitch marks. The scar on her forehead is large and uneven. She is a strong and confident child, but has begun to question the appearance of her scars. Do you perform scar revisions on children of this age?
hi, yes, i do. a few things you should know though: 1. obviously, it is most important that the child be motivated to do this because i always say i do not treat the parents but the child. psychological health and self identity are important elements for any child growing up and that plays a large part in my decision to help someone. i can best gauge that with an interview of the child. 2. in general, scars heal worse the younger you are. children tend to respond more aggressively to scar revision and actually build up more scar tissue that may require more injections afterward to manage it. all of this can add greater psychological negative impact on a child due to some discomfort. out of all the docs out there, i am one of the most sensitive to discomfort but still i can't get around it if i need to inject scar dissolving material every couple of months and laser. 3. if you don't live in Dallas, this poses another problem (see #2), especially for a child it may require more frequent treatments and after care. 4. due to a child being a child, i can either do this under local with numbing cream (probably not a great idea) or in the hospital since my surgery center cannot accommodate anyone under 18 years old unless under local anesthesia. 5. i don't take insurance. this would be cash basis. for all of these reasons, the answer is not as straightforward as perhaps you would like but this is a thorough and egalitarian treatment of the problem at hand. best, sml
Samuel M. Lam, M.D., F.A.C.S.
Diplomate, American Board of Facial Plastic & Reconstructive Surgery
Diplomate, American Board of Otolaryngology Head & Neck Surgery
Diplomate, American Board of Hair Restoration Surgery