Plastic Surgery Outpatient Program

The Plastic Surgery Program, part of the Outpatient Surgical Specialty Center at Miller Children’s Hospital Long Beach, provides surgical intervention for a variety of facial disorders, facial trauma and pressure ulcers and other wounds or injuries. Some of these disorders can be congenital or a result of an injury, including cleft lip, cleft palate, revisions of previous cleft repairs, complex facial reconstruction, facial trauma, pediatric wounds, pressure ulcers and tissue expanders for giant nevi.

Clinical Evaluation & Treatment

Upon arrival, the surgeon will do a complete physical exam and evaluation to confirm or narrow down a suspected diagnosis. Some common tests preformed include, x-rays, lab tests and other diagnostic procedures to help diagnose the condition.

Non-Surgical Care

The plastic surgery clinic is equipped to do Nasopharyngoscopy procedures to assess speech disorders, minor wound debridement, jaw wire removal and wound care and dressing changes.

Nasopharyngoscopy Procedures
In resonance disorders and velopharyngeal dysfunction, it is important to determine the cause, size, and location of the velopharyngeal opening. The nasopharyngoscopy procedure (nasendoscopy) involves passing a very narrow scope through a child’s nostril to the back of the nose. This allows the surgeon to view the top of the soft palate (velum) and the action of the entire velopharyngeal valve during speech. Nose spray of a topical anesthetic and a decongestant are usually given to the child before the procedure to help with discomfort. The child will be asked to repeat sentences and words during the procedure.

Minor Wound Debridement
The medical removal of a patient's dead, damaged or infected tissue to improve the healing potential of the remaining healthy tissue. This treatment is often used for children with low voltage minor electrical injuries or burns.

Jaw wire removal
The plastic surgeon will remove the arch bars, wire and brackets after intermaxillary fixation (IMF)—the temporary locking of the upper and lower jaws together by a wire or rubber bands. The wire or rubber bands are connected to arch bars (metal bars with hooks that are wired to upper and lower teeth). Metal orthodontic bands with brackets ("braces") are also glued onto the teeth. While the jaws are wired shut, only liquid nourishment is possible. The length of time the IMF is in place varies with the extent and severity of the fracture, but the jaw wire removal can occur between three and six weeks.

 

Plastic Surgical Care

Many times plastic surgical care is needed to help restore function, either from a congenital defect or from an injury sustained, and/or to help improve cosmetic features of a child, because of injury or defect. Leading pediatric plastic surgery procedures such as cranial vault remodeling for craniosynostosis, distraction osteogenesis of the mandible, midface and cranium for various congenital conditions are done at the Surgical Center at Miller Children’s. Miller Children’s plastic surgeons work closely with other pediatric sub-specialists at Miller Children’s for consult on their surgical cases.

Follow-Up Care

Most patients will be asked to complete post-operative follow-up care at the Plastic Surgery Center to ensure that there are no complications from the surgery and that the patient is recovering well. This typically happens with seven to 10 days following the surgery. Follow-up visits are generally continued every six months to one year depending on the type of surgery or until the child is ready to seek follow-up care at other Miller Children’s outpatient specialty centers.

Visit the Plastic Surgery Outpatient Clinic.
 

www.memorialcare.org

Miller Children’s Hospital Long Beach
2801 Atlantic Ave., Long Beach, CA 90806
(562) 933-5437

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MemorialCare Health System is a not-for-profit integrated-delivery system which includes Long Beach Memorial Medical Center, Miller Children’s Hospital Long Beach, Orange Coast Memorial Medical Center and Saddleback Memorial Medical Center in Laguna Hills and San Clemente. Our community-based hospitals are located in Southern California in both Los Angeles County and Orange County. Copyright © 1999 - 2009, Memorial Health Services. All rights reserved.