Q: My 5 year old daughter fell on a metal fireplace about 3 months ago and has been left with an oblong dimple across her right cheek that turns in significantly when she smiles. We have seen a plastic surgeon who thinks we are best to do nothing for say ten years. I am assuming this is because as she grows her face will change and also by the time she is 15 she will be able to make her own mind up about surgery. What would be your opnion on operating on young children and are there benefits to waiting?
A: Given that injury is only a few months old and she is five years of age, there is still a chance that time and healing will make the cheek dimple better or it may go away completely. That is still to be determined and you will know how permanent the dimple is by one year after the injury. If there has been no change or significant improvement by then, then one can consider corrective plastic surgery. My philosophy on the timing of ‘cosmetic’ plastic surgery procedures in children is that it is a parental decision until the child is a teenager. Once puberty hits, it then becomes a patient-driven decision. Either way the treatment would be concentrated fat injections into the depressed cheek area. The only advantage to waiting is in the first year after the injury to see how much improvement is obtained naturally so surgery might be avoided.