Guide to early surgical management of lip hemangiomas based on our experience of 214 cases.

BACKGROUND: Hemangiomas are the most common vascular lesions in infancy. The majority of hemangiomas occur on the face and cause significant parental distress because of their high visibility. Traditionally, they have been managed by a "watch and wait" approach due to their known propensity to improve significantly over time. This is a particularly difficult approach for hemangiomas of the lips due to their high visibility and their tendency to leave residual deformity even after resolution.

METHODS: The authors performed a retrospective chart review of pediatric patients who underwent surgical excision of upper and lower lip hemangiomas at Children's Hospital Los Angeles between 1992 and 2006.

RESULTS: The authors identified 214 patients with an average age of 23.6 months at the time of surgery. All patients had improvements in lip appearance, with minimal complications. No transfusions were required, and all but two patients (lip switch flaps for major tissue loss) were managed on an outpatient basis. Overall, complications were minimal, with a high degree of parent satisfaction.

CONCLUSION: The authors conclude that many children would benefit from early excision and present guidelines for the early surgical management of lip hemangiomas.