Children's Plastic Surgery (CSSG)
Children who need plastic surgery often have complex medical needs best met by a team of pediatric specialists from many different disciplines. You can find those specialists in the region’s only plastic surgery practice just for children at Children's Hospital of The King's Daughters.
At Children’s Plastic Surgery, all of our services are designed specifically to meet the medical, developmental and emotional needs of your child. We offer quick access to pediatric experts in neurosurgery, genetics, dermatology, orthodontics, oral surgery, ophthalmology, developmental pediatrics and speech, physical and occupational therapy. We’ll care for your little one in a setting created to make children comfortable. And we’ll make every effort to take good care of you, too, with the information, respect and compassion you deserve.
What conditions do you treat?
Knowledge, experience, compassion
Dr. George Hoerr (rhymes with “care”) leads our pediatric plastic surgery team. Dr. Hoerr graduated from the University of Missouri Medical School and completed residencies in general and plastic surgery at EVMS and the University of California at Irvine. He did his fellowship in pediatric plastic surgery at USC/Children’s Hospital of Los Angeles.
Dr. Hoerr has years of experience, education and training, but he also has something equally important that can’t be taught: a great rapport with children and parents. His unique combination of warmth and expertise sets his patients and their parents at ease.
Dr. Hoerr’s services are backed by CHKD’s renowned surgery program and its specialists in pediatric anesthesiology, neurosurgery, oral surgery, ENT and ophthamology, to name just a few. Our staff also includes one of the hospital’s top nurse practitioners, who has advanced training in wound care.
Conditions We Treat
Children’s Plastic Surgery cares for a wide variety of conditions, including but not limited to the following.
Cleft Lip and Palate
Cleft lip and cleft palate occur early in fetal development when the sides of the lip and/or the roof of the mouth do not fuse together as they should. A child can have cleft lip, cleft palate, or both. Most babies born with a cleft are healthy otherwise with no other abnormalities, but clefts can cause feeding difficulties, ear and hearing problems, speech and language delays and dental problems. For this reason, care is best administered by a team of specialists from plastic, oral and ear nose and throat surgeries as well as speech and hearing specialists. Both cleft lip and palate occur in a range in severity. Children with more profound clefts may require a series of surgeries to correct their conditions. The first surgeries are usually done while the child is still an infant.
Craniosynostosis (Abnormal Head Shape)
An infant’s skull consists of several plates of bone separated by cracks called “sutures,” which slowly grow together, forming solid bone as the baby grows. In children with craniosynostosis, the sutures close too early, causing problems with normal brain and skull growth. Positional plagiocephaly, flattening of the head from staying in one position too often for too long, is one type of craniosynostosis. It normally does not require surgery, but other types of craniosynostosis do. In these cases, surgery is usually required during infancy, to reduce the pressure on the growing brain and to correct the deformities of the face and skull bones.
Vascular Birthmarks
There are many types of vascular birthmarks including hemangiomas and vascular malformations. When birthmarks require treatment, we use medications, laser treatments, surgery or any combination of the three, depending on the type of lesion.
May be present at birth (as a faint red mark) or may appear in the first months after birth. Strawberry hemangiomas become visible within the first few weeks of life and grow rapidly for about six to nine months. Then they gradually lose color and shrink. Most resolve on their own without treatment.
Vascular malformations are growths made up of arteries, veins, capillaries or lymphatic vessels. A port-wine stain is a flat, pink, red or purple mark that appears at birth, often on the face, and continues to grow as the child grows. Port-wine stains do not go away, but can be faded significantly or removed by laser treatments. Other types of vascular malformations include lymphangiomas, venous malformations and arteriovenous malformations.
Dr. Hoerr has a special interest in ear reconstruction and is one of few surgeons in the country participated in the development of exciting new treatments in ear reconstruction at Children’s Hospital of Los Angeles. The traditional method of reconstruction uses the child’s own rib cartilage to build the ear. This process takes several trips to the operating room, which can’t begin until about the age of 6, because children don’t have enough cartilage before then. The pioneering treatment Dr. Hoerr performs involves the use of synthetic material, which the child’s skin grows around, to build or repair the child’s ear. This procedure can be started much earlier, usually around age 3, and is less traumatic for the child since it doesn’t involve the removal of cartilage.
Children present a unique challenge when it comes to trauma care because they are still growing. Scarring, particularly of the skin over joints, can cause serious mobility issues, not to mention life-long issues with self-esteem. Plastic surgeons know how to repair skin damaged by burns, abrasion, cuts and other trauma in a way that maximizes healing, maintains normal function and minimizes scarring and aesthetic damage. Dr. Hoerr can also improve the function and appearance of scarring from previous surgeries.
Microtia is Latin for “small ear.” Children with microtia are born without full ears. The condition ranges in severity. Some children have a partial ear. Some have a somewhat normal, but small ear. Others have no ear at all.
Is hearing affected?
Some children with microtia also have a condition called “aural atresia,” which is characterized by the lack of an ear canal and the internal ear structures needed for hearing. Like microtia, aural atresia most commonly occurs on one -- not both -- sides of the head, so children will often have normal hearing on the other side.
Why does it occur?
In most cases, there is no known cause of microtia. However, microtia can occur as part of a larger syndrome such as Goldenhar or Treacher Collins syndromes, which can affect other facial or body structures.
How is microtia treated?
The first step is a thorough physical exam by a pediatric plastic surgeon to rule out complex craniofacial syndromes. Hearing tests and hearing aids, if needed, may also be part of the early treatment program.
As children reach the preschool stage and beyond, they become candidates for surgical ear reconstruction. Pediatric plastic surgeons use several different methods for ear reconstruction. In some cases, cartilage from the patient’s own rib is used to construct a new ear. In other cases, surgeons build an ear using synthetic material, and stretch the patient’s skin over it to look natural. Your surgeon will help you select the best method, based on the age of the child and the severity of his or her microtia.
The need for hand surgery can arise from birth defects or traumatic injuries. Birth defects of the hand include fused fingers, extra fingers, missing fingers or malformed fingers. Surgical corrections may be fairly simple or extremely involved, depending on the degree of the problem.
It is important to treat the skin of the hand properly after injuries because scarring can lead to limited hand mobility. Treatments for burns, injuries that require many stitches or lengthy immobilization of the hand should include care by a pediatric plastic surgeon.
Gynecomastia is abnormally growth of breast tissue in males. It often occurs when hormones fluctuate during puberty and resolves on its own with no treatment in a matter of months. The condition can also be caused by some chronic illnesses or conditions, medication and marijuana use. Although gynecomastia rarely causes medical problems, it can damage a young man’s self-esteem and hinder his participation activities. In these cases, surgical reduction of breast tissue can make a tremendous difference in quality of life.
Keloids are thick, raised scars that grow at the site of wounds. People with darkly pigmented skin are more prone to developing keloids than fair-skinned people. Keloids can occur anywhere on the body, even from insignificant skin injuries, such as small cuts, ear piercings or bug bites.
Keloids are challenging to treat because they often recur. In such cases, particularly when the keloids are large, disfiguring or interfere with movement or clothing, the best treatment is surgery to remove the scar followed by radiation therapy on the same day.
Plastic surgeons can help restore function and appearance to areas of the body damaged by burns, lacerations, dog bites, infection, tumors and other injuries and illnesses. In these situations, care may involve a team of specialists who will collaborate to help your child make the best possible recovery.
Success Stories
One of the most amazing things about plastic surgery is the ability to transform a child's life. Click to see some before and after pictures of Dr. Hoerr's patients.
Appointments and Consultations
Children’s Plastic Surgery treats newborns through age 21. We accept most major insurances and offer appointments and perform surgery at the following locations:
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Norfolk: Children’s Hospital of The King’s Daughters, 601 Children’s Lane.
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Newport News: CHKD Health and Surgery Center at Oyster Point, 11783 Rock Landing Drive (Outpatient surgery only.)
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Virginia Beach: CHKD Health and Surgery Center at Princess Anne, 2021 Concert Dive (Beginning in late 2008. Outpatient surgery only)
How do I make an appointment?
To make an appointment or inquire about insurance requirements, please call (757) 668-7713.