Craniofacial & Pediatric Plastic Surgery

Created in 2017, the Division of Craniofacial & Pediatric Plastic Surgery through Michigan State University College of Human Medicine's Department of Surgery, utilizes the latest technological advancements in the treatment of pediatric and facial reconstruction.

MSU Health Care Surgery provides patients peace of mind through our successful outcomes which are supported by our:

• Advanced training
• Case numbers performed
• Virtual surgical planning
• Postoperative care from our highly skilled team
• Complex pediatric team coordination and care

Services & Patient Resources

• Cleft & Lip Palate Spectrum
  Dr. Bray leads the Sparrow Multidisciplinary Cleft Lip & Palate Clinic which received national recognition with a listing as an approved team by the American Cleft Palate-Craniofacial Association in 2020. The listing means the Sparrow Cleft Palate and Craniofacial Team meets the gold standard for cleft care.
  

  The clinic is the only practice in Mid-Michigan to receive such recognition, a reflection of the personal commitment of Caregivers from Sparrow and MSU Health Care to this special population of pediatric Patients. The designation means the clinic is certified for five years as a Cross-Specialty Team and will be listed on cleftline.org for Patients searching for accredited practices.

  Read more about certification here: https://www.michiganbusinessnetwork.com/blog/sparrow-cleft-lip-palate-clinic-receives-national-recognition

  Her services include:

  • Cleft lip
  • Cleft palate
  • Velopharyngeal insufficiency
  • Alveolar bone graft
  • Cleft lip or palate revision
  • Orthognathic (jaw) surgery
  • Cleft rhinoplasty

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  Patient Resources
  
  Learn more about cleft lip and palate from Dr. Stephanie Bray, Director of Pediatric Plastic Surgery and Craniofacial Services at MSU Health Care Surgery.

• Head Shape Abnormalities
  • Craniosynostosis
  • Positional plagiocephaly
  • Syndromic craniosynostosis
    • Apert
    • Crouzon
    • Muenke
    • Pfeiffer
    • Saethre-Chotzen
• Pierre Robin sequence
  • Jaw distraction
• Congenital Ear Malformations
  • Microtia
  • Lop/cupped ear
  • Constricted ear
  • Prominent ear
  • Ear molding

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  Patient Resources
  
  Learn more as Stephanie Bray, MD, MS, FACS, crainofacial & pediatric plastic surgeon at MSU Health Care Surgery discusses cleft palate and ear molding for pediatric patients.
  

• Jaw Deformities
  • Cleft related
  • Non cleft related:
    • Idiopathic
    • Syndromic
    • Goldenhaar syndrome
• Vascular Malformations
  • Hemangioma
  • Venous malformations
  • Lymphatic malformations
  • Capillary malformations/port-wine stains
  • Arteriovenous malformations
• Pediatric Hand
  • Syndactyly
  • Polydactyly
  • Constriction Band Syndrome
  • Clinodactyl
  • Genetic Hand abnormalities
    • Apert
    • Crouzon
• General Pediatric Plastics
  • Dermoid and other cysts
  • Congenital nevus
  • Moles
  • Scars (including keloids)
  • Pediatric facial and hand trauma
  • Pediatric breast or body reconstruction
    • Poland syndrome
    • Juvenile Breast Hypertrophy
    • Gynecomastia
• Facial Trauma and Reconstruction (Adult & Pediatrics)
  • Facial Skin Cancers
    • Basal cell
    • Melanoma
    • Squamous cell
  • Facial Asymmetry
    • Syndromic
      • Goldenhaar
    • Non-syndromic)
• Trauma Management

  Comprehensive reconstructive surgery of the hand and face. MSU Health Care Surgery serves Sparrow Emergency and urgent care facilities with hand and facial trauma call.

  • Hand fractures
  • Jaw fractures
  • Local soft tissue coverage
  • Nerve injuries
  • Pan facial fractures
  • Pediatric facial fractures
  • Tendon injuries

• Scar Care Instructions

  Surgery | Scar Care Instructions
  UNDERSTANDING SCARS

  Scars form whenever something “breaks” the skin for example:

  • Injury such as cut burn or deep scrape
  • Disease process such as chicken pox scars
  • Surgery

  Once the skin has broken, the body heals by laying down fibrous or connective tissue that causes a scar to form scars usually take 12 to 18 months to fully mature. During that time, they go through a remodeling process. Many scars that are under attractive in the first few months may greatly improve over the course of a year. In the first few months, they may be pink and raised (hypertrophic) then soften, flatten, and lighten over the remaining 9 - 10 months. Scar tissue is not as strong as normal skin, and therefore, depending on location, direction intention, and may widen overtime, no matter how carefully the wound was closed. Some scars may even remain permanently thick (hypertrophic) or form an excessive amount of scar tissue (keloid) despite best efforts to minimize scarring.

  If the incision has been closed with absorbable sutures and Steri-Strips, scar treatment can begin about two weeks later after the Steri-Strips have been removed if the incision is completely healed. If permanent sutures were used and sutures removal is necessary, scar treatment can begin after suture removal according to the surgeon’s recommendation.

  PHASES OF SCAR TREATMENT

  Early Treatment	Mid Treatment	Late Treatment
  3 weeks – 1 year	1 year – 3 years	Scar Revision

  
  TREATMENT OPTIONS FOR SCARS

  There are many ways to treat a scar:

  • Time
    • Since scars naturally improved over 12 to 18 months you may need to be patient.
  • Sun Protection (sunscreen, hats & clothing)
    • It is very important that all scars be protected from the sun. Scars that become sunburned will remain red and unsightly for a long time, possibly permanently. It is very important to use sunscreen on all scars, especially new, and mature scars. It is also important to use hats and other clothing to protect the scars and the rest of your skin from skin damage.

  • Massage
    • The collagen in the scar tissue remolds over the course of a year. Gentle massage can help this tissue to flatten, creating a smoother appearance. Moisturize in the form of vitamin E, cocoa butter, or lotions.

  • Expensive Scar Cream
    • There are many expensive scar creams available in drugstores and on the Internet, there is no evidence that these creams (such as Mederma) have any effect on improving scar quality. It is likely that massage is the main important factor, we do not recommend purchasing these creams and lotions.
  • Silicone Rubber
    • Silicone rubber is one of the most effective forms of scar therapy. Silicone products help hypertrophic scars flatten and lose their redness faster than untreated scars. A variety of products are available
      • Silicone Gel (such as Scar Away, Kelocote, Spectragel, New Gel) is a thick clear gel which comes out of a tube. The gel may be easier to use for scars on areas of the body with a lot of mobility, where sheets won't stick. It is also good for more obvious areas such as the face.
        • Silicone gel may be applied once or twice daily for 3-4 months. However, silicone may be recommended for longer periods of time if the scar remains red and elevated. We don't fully understand why silicone improves scars, but studies have shown that using silicone is better than leaving scars untreated. Silicone sheeting, tape and gel can be purchased at many local pharmacies. You can also find silicone products online. Look for products which are made mostly of silicone. These products should give you similar results.
      • Silicone Sheets (such as those from Scar Away, Biodermis, Rejuveness or Septra film) or silicone tape (such as Mepitac or Safetac available online) have a light adhesive backing and are usually held in place with tape or gauze they can be cut to the correct size over the scar and are generally used on the body and extremities.
        • Silicone sheets and silicone tape should be applied constantly for at least 3-4 months. They should be removed daily for bathing and then reapplied. If irritation develops, or if this scar is in an obvious location, the sheet can be worn at night only.
      • Steri-Strips
        • Steri Strips (paper tape reinforced with thread) may be used to reduce scar thickening and especially scar widening. Your surgeon will show you how to apply these but in general they are placed in a way that pulls the edge of the scar together.
        • To be the most effective, the Steri-Strips or paper tape need to be in place almost constantly. Since scar widening and healing can take one year or longer, the Steri-Strips or tape will need to be used for the entire time. Some children react to the adhesive material in the tape and may see redness or blistering at the site. If this occurs, stop using the Steri-Strips for one to two weeks until the area heals, and then try using them again. If a reaction occurs again, stop using the Steri-Strips.

  • Lasers
    • Scars that remain pink and raised may respond to pulsed yellow dye laser therapy.
    • The light is absorbed by blood vessels in the scar and may result in softer, lighter scars. At first the scar will appear darker due to bruising caused by the rupture of the blood vessels. This bruising will fade over 2-3 weeks. It may take at least a full month to see if the laser treatment has been effective. Several treatments may be needed for best results. There is a mild to moderate stinging discomfort from the laser pulses. We apply medicated cream 20 to 30 minutes prior to the laser treatment to help make it more comfortable. Lasers are usually reserved for scars that are still pink after 12-18 months.
  • Steroid Injections
    • Scars that remain pink and raised may respond to pulsed yellow dye laser therapy.
    • Kenalog (triamcinolone) is a long-acting local steroid injection that works to soften and may help to shrink hypertrophic or keloid scars. It takes at least one month for the steroid medication to be completely absorbed, so injections are usually spaced 4-6weeks apart.
    • A series of injections may be needed for the best result. The injections may be uncomfortable during the procedure, but the pain goes away quickly. Your doctor will decide if the injections are a good choice for you.
  • Compression Garments
    • Depending on the location, some scars especially burn scars may respond to gentle compression from ace wraps, sleeves, or custom fitted compression garments.
    • These garments are worn for at least 6 months or longer periods for large scars with some areas of excessive thickness, a sheet of silicone rubber can be worn beneath the compression garment. Your doctor will decide if these garments are a good choice for you.
  • Scar Revision
    • Scars that failed to heal well may be improved by surgical scar revision these may be combined with small zig zag incisions to break up a straight-line scar or to change the direction of parts of a scar to better hide it.
    • In some cases, such as with keloid scars, scar revision may be combined with steroid injections and a few days of post operative radiation therapy to decrease the risk of the scar returning and looking the same.
      • Unfortunately, there is no guarantee that any of the above methods of treatment will result in a favorable scar. In the case of surgical scar revision there is always a chance that the new scar will be very similar or maybe even worse than the previous scar.

  
  If you have further questions, please contact our office:

  Stephanie Bray, MD, MS, FACS
  James HW Clarkson, MD, FRCSC, FRCS.plast, MSC
  Miranda Cristales, PA-C, MPAS
  Ashley Day, PA-C, MPAS
  Andrew Zwyghuizen, MD, ABPS  
  
  MSU Health Care Surgery
  4660 S. Hagadorn Rd Suite 600
  East Lansing, MI, 48823
  517.267.2460

  Click here to download a PDF version of these instructions.

Hours

Monday	8:00am-5:00pm
Tuesday	8:00am-5:00pm
Wednesday	8:00am-5:00pm
Thursday	8:00am-5:00pm
Friday	8:00am-5:00pm
Saturday	Closed
Sunday	Closed