Facial plast Surg 2008; 24(1): 050-064
DOI: 10.1055/s-2008-1037451
© Thieme Medical Publishers

Management of Cutaneous Juvenile Hemangiomas

Stephen P. Smith1 , 2  Jr. , Edward D. Buckingham3 , Edwin F. Williams4 , 5  III 
  • 1Smith Facial Plastics, Dublin, Ohio
  • 2Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Medical Center, Columbus, Ohio
  • 3Buckingham Center for Facial Plastic Surgery, Austin, Texas
  • 4Williams Center for Excellence, Latham, New York
  • 5Facial Plastic and Reconstructive Surgery, Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Albany, New York
Further Information

Publication History

Publication Date:
20 February 2008 (online)


Past descriptions of vascular lesions often confused vascular malformations and hemangiomas using interchangeable definitions which led to inappropriate treatment and inconsistency in the medical literature. The work of Mulliken and Glowacki systematically delineated the difference between hemangiomas and the multiple varieties of vascular malformations. Hemangiomas are in fact as the suffix “oma” suggests true tumors exhibiting cellular proliferation on histology. Additionally, treatment has been clouded by numerous reports in the literature of near universal complete spontaneous resolution and conversely arguments that every lesion demands treatment. More recently, thoughtful studies of the natural course of hemangiomas have been completed, algorithms for intervention versus observation proposed, and effective safe treatment plans devised. The following article will be presented in two sections. The first section will review the diagnosis and natural history of hemangiomas as appreciated in modern literature and compare this to a review of historical articles. This information will then be used to describe a rational and thoughtful algorithm for observation or intervention and recommend appropriate treatment options. Special emphasis will be given to surgical technique and several cases of late involuting hemangiomas of the face will be presented.