Pediatric Plastic Surgery Referral Guidelines
A visible disfigurement can negatively impact a child’s self-esteem during critical years of development. Our pediatric plastic surgery experts specialize in the surgical correction and management of congenital and acquired conditions involving bones, ligaments, tendons, nerves and vessels.
Our team of board-certified and board-eligible pediatric plastic surgeons perform almost 1,400 procedures and more than 10,000 outpatient visits a year. The depth and breadth of our child and family-centered services help your patients improve their quality of life.
We provide expert diagnosis and management of a wide range of injuries and disorders, specializing in:
- Trauma: Fractures and other injuries to the face and hands, including finger and carpal injuries
- Craniofacial anomalies: Cleft lip and palate, including nerve injuries, tendon injuries, carpal injuries, Stickler syndrome and Pierre Robin sequence, 22q11.2 Deletion syndrome (previously known as velocardiofacial syndrome or DiGeorge syndrome), microtia and ear abnormalities, facial deformities; orthognathic maxillofacial reconstruction, craniosynostosis, plagiocephaly, hypernasal speech, hemifacial macrosomia, nasal deformities
- Hand anomalies: Arthrogryposis, burn reconstruction, cerebral palsy, complex reconstruction (including microsurgery), extra fingers or thumbs (polydactyly), fractures, fused or crooked fingers (syndactyly, camptodactyly, etc.), ganglions, hand, finger or carpal bone injuries, hypoplastic upper extremities (longitudinal deficiencies), infections, masses, missing/webbed fingers or thumbs, nerve injuries, syndromic conditions, tendon injuries, trigger finger or thumb, tumors, vascular disorders, wrist injuries
- Vascular anomalies: Vascular malformations, hemangiomas
- Congenital breast anomalies: Gynecomastia, macromastia, breast asymmetries, breast hypoplasia
Valley Children’s cleft lip and craniofacial program specializes in the surgical correction and management of maxillofacial reconstruction. Current standards of cleft care include multidisciplinary management by a qualified cleft palate team in accordance with American Cleft Palate-Craniofacial Association criteria.
The hand and upper extremity program provides comprehensive and multidisciplinary care to restore function, manage pain and optimize aesthetic outcomes through the use of intricate and precise techniques. We provide early intervention to decrease the chance of long-term disabilities including stiffness, reduced function, numbness and poor healing.
Valley Children’s pediatric plastic surgeons collaborate with a variety of clinicians for complex planning and delivery of treatment, including specialists from medical, surgical, dental, speech, hearing, genetics and psychology.
Our pediatric plastic surgery specialists are always available for consultations and urgent patient appointments.
Refer to Plastic Surgery
Refer to Valley Children's Pediatric Plastic and Reconstructive Surgery Department online through CareLink or our referral portal, or refer via fax.
Refer a patientPlastic Surgery Office Numbers
Contact Pediatric Plastic Surgery via phone (559-353-6277) or fax (559-353-5424).
Contact a Physician Liaison
Physicians can reach a physician liaison for help with referrals or other questions by calling 559-353-7229.
Download these plastic surgery referral guidelines as a PDF
Condition | Pre-Referral Work-up | When to Refer |
---|---|---|
Cleft Lip and Palate, Facial and Jaw Deformities | Histories - family, pregnancy, surgical | At birth |
Craniosynostosis |
Histories - family, pregnancy, surgical Physical examination Head and orbits CT Pediatric ophthalmologic dilated fundoscopic examination |
As soon as diagnosed with a CD of any obtained images |
Craniofacial/Facial Injuries or Paralysis |
History and physical, tetanus status For facial fractures, CT of face and coronal cuts Dental films / panorex if suspected dental injury (if available) Ophthalmologic examination if injury involves eyes/orbits |
When overall status stable with a CD of imaging preferably within one week of injury |
Upper Extremity Injuries / Trauma |
History, tetanus status Physical examination, identification of potential vascular injury Plain film X-ray of injured/deformed parts |
As soon as overall patient status is stable with a CD of imaging Replantation should be referred to microvascular centers |
Skin Lesions | History and physical |
Changing lesion (e.g., color or size) Symptomatic lesion (e.g., bleeding, pain) Anatomic sensitive areas (e.g., eyelid, lips, nose, ears, fingers) |
Tumors |
History and physical Bony tumors image with CT scan Soft tissue tumors image with MRI |
When diagnosed with a CD of any obtained images |
Breast / Chest Wall Deformities |
History and physical Endocrine work-up if necessary BMI < 30 After physical therapy treatment for neck and back pain |
Persistent gynecomastia (> 1 year) after puberty Unilateral breast enlargement Hypoplasia of breast / chest wall (e.g. Poland’s) Females after 14 years of age for breast enlargement |
Pigmented Moles, other Lumps and Bumps | History and physical | As soon as diagnosed |
Vascular Lesions | History and physical | As soon as diagnosed |
Burns | History and physical |
Small isolated burns that do not meet burn center criteria Post-burn contracture / deformity |
Hand Anomalies / Deformities: Arthrogryposis, Cerebral Palsy, Syndactyly, Trigger Digits, Polydactyly |
History and physical X-ray to determine bony involvement |
As soon as diagnosed with a CD of imaging |
Jaw (Hypoplasia) Malocclusion | Orthodontic referral for teenagers |
After 15 years of age When there are breathing/snoring issues |