ARLINGTON HEIGHTS, Ill. -- Reconstructing severe facial deformities inchildren with mental disabilities can be a hard decision for parents.Insurance companies may consider some operations to be only forcosmetic purposes and refuse to cover them. However, craniofacialplastic surgery, to correct abnormalities of the face, skull and neck,may give these children significant psychological, social and emotionalbenefits that can help them attain a better quality of life, accordingto a report in the August issue of Plastic and Reconstructive Surgeryฎ, the official medical journal of the American Society of Plastic Surgeons (ASPS).
"Plastic surgery to correct defects of the face, skull, and neck isreconstructive and functional in nature, not merely cosmetic, as someinsurance companies assert," said Steven Buchman, MD, ASPS MemberSurgeon and author of the report. "Children with severe mentalimpairments undoubtedly benefit from plastic surgery and ultimatelygain the functional tools that will help them lead a fuller life."
According to the report, a person's physical appearance canpositively or negatively influence their ability to socialize. This, inturn, can influence long-term relationships with peers and employers aswell as the ability to manage daily tasks and properly function insociety. Because social relationships are key predictors of quality oflife, children with facial deformities greatly benefit fromcraniofacial plastic surgery, allowing them to appear more normal andto help gain social acceptance.
People may use a person's facial characteristics to formopinions about traits and other personal attributes, according to thereport. In the case of a child with mental disabilities and facialabnormalities, other children may react negatively and refuse to playwith him or her, often causing the child to withdraw socially.Consistent rejection could lead to serious social impairments andimpede the child's ability to relate.
In addition, the more these children are accepted by theirpeers, teachers and parents, and the more interactions they have withothers, the better they learn. Teachers may underestimate theintellectual abilities of children with facial deformities and havecorrespondingly low expectations for their achievement. Parents mayalso unknowingly share these low expectations. By addressing thedeformities, the subconscious bias of teachers, parents and otheradults may diminish, giving the child a better chance to be exposed topositive feedback and increase their learning capability.
"Calling these surgeries cosmetic demeans the benefits thesechildren gain," said Dr. Buchman. "By fixing their deformities, wepositively change the way others interact, react and relate with them,helping shape how well they learn, socialize and adapt to the worldaround them."
Increasing insurance company denials, restrictions on coveredprocedures and a new tactic of excluding specific reconstructiveprocedures may be forcing some children and adults to live withdisfigurement or painful medical conditions. This restrictive access tocare contributed to a 10 percent decline in reconstructive plasticsurgery procedures in 2004, the ASPS reports.
The American Society ofPlastic Surgeons is the largest organization of board-certified plasticsurgeons in the world. With more than 5,800 Member Surgeons, thesociety is recognized as a leading authority and information source oncosmetic and reconstructive plastic surgery. ASPS comprises 94 percentof all board-certified plastic surgeons in the United States. Foundedin 1931, the society represents physicians certified by The AmericanBoard of Plastic Surgery or The Royal College of Physicians andSurgeons of Canada.
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