A team at Great Ormond Street Hospital has used an extraordinary technique to improve the quality of life for George Barter, 5, who was born with a very noticeable birthmark on his forehead.
Infantile involuting capillary haemangiomas affect one in ten babies. A collection of small blood vessels that form a lump under the skin, haemangiomas are, for the most part, not problematic. Most haemangiomas will have disappeared completely by the age of five to seven years and even large ones may continue to get smaller until children are about eight to ten years old. However, for children like George, who have a prominent mark in an obvious place this can be a concern.
When George was born, his mum Karen asked her GP and a local hospital paediatrician about his birthmark and was told that it would disappear in a few weeks to a few years. However, moments in his childhood made her worry. George’s birthmark was very fragile and would often become dry and form scabs. One day he banged his head with another child and it bled a lot. How other people would react to George also worried Karen: “There was an incident when George was a baby and a 14 or 15 year old boy came by, stopped and stuck his head right inside the pram. It was quite hurtful to see that happen.”
Concerned that he would be teased as he got older Karen found the Birthmark Support Group and they recommended getting a referral to a specialist, suggesting Great Ormond Street Hospital. At the hospital it was determined that George’s mark was a rare type of cavernous haemangioma, that it would not go of its own accord and that he should have surgery.
In order to be able to remove George’s birthmark the doctors expanded two inflatable sacs to under his hairline, allowing them, over time, to stretch the unblemished skin. The tissue expanders were put in in January 2010 and removed just 3 months later. George then went into surgery.
His surgeon, Neil Bulstrode, is very happy with the result and how George has coped: “It has been great to see how happy George is following the surgery. He had been through a great deal with such an obvious mark.”
“Due to the size of the lesion we had to stretch up the non affected skin of the forehead to be able to close the wound when the birthmark was excised. This meant having balloons under the skin inflated every week over a 3 month period. This can be quite shocking to see and difficult to live with but George and his family coped brilliantly. This has all been worth it as the resulting scar has faded extremely well. ”
George has recently started school with no worries, and he and his mum are immensely happy with the surgery: “It’s brilliant now. George can go out on his scooter. I’m not worried about him falling and hurting his head. This surgery has made his life a lot better.”