Surgery for DS’s facial birthmark

[BeCalmFox]

Hi everyone

First time poster really looking for some views.

my DS (4) was born with a large red birthmark on his face. It was originally diagnosed as a port wine stain but after it faded significantly in his first year it was diagnosed instead as very extensive stork bites or salmon patches. It has continued to fade although at a much slower rate and, until now, hasn’t caused him any problems and other children haven’t mentioned it. It’s faint pink now and not immediately noticeable unless you spend a bit of time with him. It’s more noticeable when he’s cold or excited or upset etc. It is definitely still there though and I’m conscious of how perceptive and cruel other children can be. He starts school on august and we have just been given an NHS appointment to have it treated by laser. The procedure requires general anaesthetic and 10 days off nursery. It may also require repeated procedures depending on the skin’s reaction.

My DH and I are torn about what to do. On one hand we don’t want to put him through an operation requiring GA and a disruption to his life for something that is not medically necessary, massively noticeable and may continue to fade further.

On the other hand, I am concerned about him being bullied or treated differently because of it and this affecting his confidence. If we waited another few years, I’m concerned that some damage may have already been done in this respect. We may have a chance to just deal with it now and draw a line under it before school.

AIBU to put my DS through this procedure?

YANBU. A family member has a similar birthmark that covers half his face. The amount of comments he's had about it throughout his life have really affected him. It's the first thing people see when they meet him.

He started wearing camouflage foundation in his early 20s and then paid for laser surgery in his 30s. The difference to his confidence is amazing. He wishes laser treatment was available when he was a child.

My DP has an extensive port wine stain covering his eye forehead and part of his scalp. He hated it growing up and says he was bullied and shy because of it. There wasn't the treatment back then. I love it. I barely see it because he's gorgeous and he's just him. But I can see he gets a bit stressed when children ask about it for example now even as an adult. I think I'd give it a go and see how his skin reacts. If it doesn't help there is nothing lost? On the other hand I know there isn't anything crueler than children but if it's faint and fading it may well go down further naturally?

It's a tough one but good luck with whatever you choose.

I'd have it dealt with now while he's young and will heal well.

It's not something I would have done - my DD was born with a fairly large facial birthmark across her forehead which has mainly faded now, more visible when she's upset etc. But that doesn't mean I think that's the "right" decision and that you would be unreasonable to do it. I think it's a personal decision, not something with one universal correct answer.

A family member has a birth mark covering his entire arm and one side of his chest, he had a tiny patch of laser as a late teen and was crying with the pain of it. Didn't bother again. At least your DS will be asleep.

Deal with it now before him and other kids become aware of it and you have to be put on another waiting list

Hi my son is 4 and has a port wine stain in his face. We are going ahead with the treatment. Happy to discuss further in messages.

Hi,

My daughter has exactly this.

Happy to talk in private and show you (privitased) photos how how she looks now vs a baby.

We gave her the choice at 5. And she said she loved her 'pink cheek'

And didn't wnat it to be removed.

She's 15 now and refuses to wear foundation as it covers her birthmark and she 'doesn't feel like herself without it'

We don't even notice it anymore.

But it is more visable in the cold and I'm sure other people notice it.

We've only had 1 instance of someone being rude about it in 15 years

I was wondering how old he was when I saw your thread title.

My DSis was born with a birthmark between her eyebrows but it had faded mostly by the age of 4. If he had been under 2 I’d say give it time.

If it’s still visible and noticeable (I would ask a third party as parents we’re are often crap at taking an objective view - although being offered NHS treatment for it means it must hit a threshold I suppose) then I’d go for the surgery. It’s scary and I understand it feels a bit weird to do a ‘cosmetic’ surgery for a preschooler. But think of it less like a nose job and more like braces. The difference is, unlike braces, he’s young enough for it to be sorted before he wishes you’d done it.

I feel for you (my 2yo DS had hernia surgery in January and I get how awful the idea of contemplating a GA is!). But I think this is one where you’d regret it more if you didn’t do it, than if you did.

My son has a different birthmark on his top lip, he is 5 and started school last September. He had one bigger issue which the school dealt with immediately. When viewing schools I specifically asked about how they would deal with a birthmark comments situation and it definitely helped me rule out schools with the way they responded. Now age 5, he really does notice people looking, it is affecting his confidence and doesn't want to attend parties, etc, where there are lots of people. He did have treatment as his birthmark affects the muscles and gave him ear infections, so his was a must and will need further treatment this year. Unfortunately, as a teacher, I see the cruel comments that others make regularly, but it is actually mainly from the adults and not so much the children. I think treatment is worth a shot to see if it works for your child. I'm currently looking at treatment for my son in the US. It is such a hard choice, but unfortunately people are cruel.

I say this knowing that when my son had his first treatment at two I missed his birthmark, his has grown again and I know he needs treatment not just for visual reasons but I will miss it, it's part of him and I love it. I don't really 'see' it anymore.

Wishing you luck! Sorry for the waffle, a lot of feelings with this post.

Thanks everyone. These are all helpful perspectives. The reason it’s such a dilemma for us is that it really isn’t that noticeable on a day to day basis. It’s certainly not disfiguring and the vast majority of people won’t notice it. If it was a noticeable port wine stain I don’t think we would have any doubt about treating it. But we’ve never had any comments about it yet. I’m just worried that as they get older, kids at school do notice it and make more of it (as kids tend to do). He’s such a confident little boy and I hate the thought of something (that I could have had treated) affecting that.

If you're being offered it I'd take it

He had one bigger issue which the school dealt with immediately. When viewing schools I specifically asked about how they would deal with a birthmark comments situation and it definitely helped me rule out schools with the way they responded.

This was interesting to read-what sort of responses did schools give?

I have a facial disfigurement from something that happened to me as a child. I have always been conscious of it and in many ways it ruined my early adulthood. Kids are cruel but as a PP said, some adults are vile as well. If I had a magic wand to take mine away I would grab it with both hands. People who know me well say it’s part of me and they don’t notice it. But when I meet new people I’m very conscious. I don’t know if it’s worse being a girl with something ‘wrong’ with your face but I think it’s probably as bad for boys.

Sending much love to you and your little one. You sound like a wonderful Mummy to your little boy. ♥️

I was born with a port wine birth mark on my face. I had laser on it as a child. I was put under GA for the laser sessions (not sure why your DS would require 10 days off nursery?? I'm fairly sure I just went to nursery/school as normal). I didn't tolerate the GAs very well. I used to resist and get very upset, so in the end my parents decided to stop taking me for laser. I was never, ever bullied and it was barely mentioned by any other kids throughout my childhood to the point I pretty much forgot about it, even though it was/is noticable. I've had way more comments as an adult "what's happened to your face?" "Has someone punched you?" amongst other things. People say kids can be cruel, but honestly it has been older people who have upset me the most in my life with their comments. I have resumed laser treatment as an adult, because I've read that port wine stains can become raised and bumpy with age, and I don't want that. Though if your son doesn't have a port wine stain then that isn't really an issue. I do wish my parents had continued with my laser treatment as a child though. Although I understand why they didn't.

DD has a friend with a large port wine birthmark on one side of her face. She doesn't often cover it and no one is unkind about it - it is just 'her' - she is beautiful and it is part of her. But I realise not everyone can embrace things in that way.

DS was born with a far lesser mark on his forehead - it was quite noticeable as a toddler and even more so when he was sad or angry , but over time it faded and by the time he was about 10 it was invisible. I am attaching a picture so you can compare it to the intensity of your DS. If it is similar, I can assure you it has completely gone - not visible when he is cross / suntanned / cold - it's completely gone.

Personally, I would be concerned with what kind of message having it removed would send to your son.

Presumably you think he is beautiful and perfect just the way he is, but by opting to have it removed on his behalf (because he is not yet old enough to choose for himself) suggests otherwise.

I would be a bit sad if my parents changed something about my appearance, it suggests that it was ugly or needed changing, which based on your description does not seem the case.

Not judging, I can see you have his best interests at heart, just offering another perspective.

I would get it done while he’s young and unlikely to remember. The NHS have offered treatment so they have a good reason for offering it.

My DS1 has a large port wine stain on his hip, which triggered alarm bells at school a few times over the years as they thought it was a big bruise! He went through a stage in early teens of being very self conscious about it (he’s a swimmer).

Had it been on his face I absolutely would have had it treated when he was young. Treatment should reduce/get rid of it which will minimise/get rid of potential teasing. Kids can be nasty beggars.

I have another perspective - I am in my mid thirties and have a port wine stain on my face which my parents got treated several times when I was a toddler. I found it really traumatic and remember parts of it - biting an anaesthetist in particular! I had several general anaesthetics (5 or ) and now as the parent of a 3 year old (who is also different and stands out but for a different reason) I really can't understand their logic. My own child has had a GA for an MRI and I could never put him through several GAs for something that wasn't even essential.

Sorry that's probably not what you want to hear but I also saw you said the birthmark isn't that obvious too so if it were me I wouldn't go ahead.

My 9yo dd had/has a nasal bridge haemangioma. She has had many procedures over the years as although it was significantly shrunk with medication, it left behind fatty tissue that was removed by a rhinoplasty, and that left behind wrinkled, baggy skin and red capillaries.

The latest round of treatment was laser, 1 test spot under local anaesthetic and 2 surgeries under general anaesthetic. Unfortunately the pulsed dye laser didnt have much effect and as dd got older she became increasingly reluctant to go through treatment and now though there is still another (fragmented?) laser to try, dd doesn't want to try again as she hates the hospital environment, the needles, all of it. I can't say I blame her, having to hold the gas mask over her face as she resists and struggles is pretty unpleasant for me too.

Maybe when she hits puberty she will rethink further treatment, but I worry that she will age out of NHS treatment as I imagine over 18 it will be considered cosmetic unless proved to be severely detrimental to mental health.

It it horrible to have to make these type of decisions for your child and have the burden of wondering if you are doing the right thing. No advise, but sympathy, sorry.

We get my child's extensive facial port wine stain birthmark lasered every 6ish months under general anaesthetic on the NHS. We started when they were 3 (now 7) and it's made a huge difference to keeping the skin healthy and killing the blood vessels. My child only has a few days off school when they have it done, so they don't knock their face while it's at the most sensitive.
Personally, if my child's birthmark would've faded on its own I'd have just left it and taken a watch-and-wait approach, as loads of children have stork marks on their forehead, or even hemangiomas (strawberry marks) that fade by the time they are junior school aged. But it a personal decision. Treatment for the port wine stain was the right decision for us as they do grow/thicken and can cause hypertrophy/swelling if left untreated. Go with what you feel peace about.

Slightly different scenario but my son had a hemangioma on his face and my husband and I had to decide whether to treat it or leave it in the hope that it would disappear by itself.

In the end we decided to treat it, mainly because other people were commenting on it and we didn't want him to feel self conscious when he was old enough to understand.

I'm so glad we did have it treated, it was absolutely the right decision.

If your son's birthmark is considered a cosmetic problem and the NHS are willing to treat it, I would have thought that means the treatment itself is very safe. I very much doubt they'd risk his health for something purely cosmetic otherwise.

I would have the treatment.

Stork mark over top lip on my DC. Very visible as baby/toddler. Is now virtually invisible at 8 years.

Personally, I wouldn’t have considered GA for laser. Although would have for port stain/if it was mega visible.

Question: could it be a future option if teen without GA and assuming it bothers them?

Thank you. Yes, definitely an option to do without GA when he’s older. My worry is that the damage to his confidence will be been done by then and also that (as it’s painful) he’ll ask us why we didn’t just do it when he was small. I don’t think we can win really?!

Thank you. For context, the reason that NHS are willing to treat is, I think, driven by the fact that when he was out on the waiting list it was much darker. We’ve waited around 3 years and it’s changed a lot since then.