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 at Children's Hospital of The King's Daughters, the region’s only plastic surgery practice just for children.
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 convenient
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 more than 20 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, the region's
only surgery program dedicated exclusively to children. 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; which occurs when an infant's
head becomes misshapen from sleeping in the same position too often can look like
craniosynostosis, but does not require surgery. For craniosynostosis, 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.
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.
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. Dr. Hoerr will help you select the best method, based on the age of the child and the severity of his or her microtia. The same technique used for microtia can also be used to reconstruct
ears after trauma.
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.
Girls with very large, pendulous breasts can have chronic neck, shoulder and back pain, poor posture and problems with body image. Surgery to remove some of the breast tissue can be performed in the late teen years, alleviating symptoms early in life.
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.
Dr. Hoerr and his team can help minimize scarring and maximize normal function and appearance to areas of the body damaged by burns, lacerations, dog bites, infections, tumors, pressure sores 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.
Dr. Hoerr also treats keloids, thick, raised scars that grow at the site of wounds.
Keloids are challenging to treat because they often recur. But when they are large, disfiguring or interfere with movement or clothing, the best option is often surgery to remove the scar followed by radiation therapy on the same day.
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:
Norfolk: Children’s Hospital of The King’s Daughters, 601 Children’s Lane
Newport News: CHKD Health and Surgery Center at Oyster Point, 11783 Rock Landing Drive (Outpatient surgery only.)
Virginia Beach: CHKD Health and Surgery Center at Princess Anne, 2021 Concert Drive
Do I need a referral to make an appointment?
This depends on what kind of insurance you have. If you have an HMO, you must:
- Get a referral from your child's primary care physician before you call to make an appointment.
- Make sure your referral has not expired. Many are good for only 30 days, so check yours before you come to your appointment. If your referral has expired, call your primary care physician and explain your situation. In most cases, your primary care physician will provide a new or extended referral.
- Bring the referral with you to the appointment. If you do not have a referral, or if the referral you have is expired, your HMO will not pay for your appointment.
If you have fee-for-service insurance or a PPO, you do not need a physician's referral to make an appointment.
We offer in-depth information about insurance in our Billing and Insurance section.
How do I make an appointment?
To make an appointment or inquire about insurance requirements, please call (757) 668-7713.