Vascular Birthmarks Conditions: Capillary Malformation

These vascular malformations are frequently referred to as “port wine stains.” They tend to involve skin and produce a deep red or purple coloration. Treatment is largely with pulsed dye laser or IPL. In some cases, capillary malformations may be associated with a larger condition called Sturge-Weber syndrome.

What is Capillary Malformation?

Capillary malformations, or “port wine stains,” classically present as flat or slightly raised, red or purple lesions. They can occur virtually anywhere on the body. These malformations are typically harmless, but can potentially ulcerate and produce bleeding or pain.

More extensive malformations may be associated with certain syndromes and with internal organ involvement, such as in the brain. An interesting relationship between arm or leg overgrowth and capillary malformations are seen on occasion.

Treatment of capillary malformations may include surgery or laser therapy. Each patient’s care must be individualized. Surgery may be indicated in areas of nodule formation or frequent skin breakdown or bleeding. Also, a small capillary malformation can be excised completely or potentially reduced in size.

Before and after photo of child’s face after treatment with pulsed dye laser for capillary malformation, or port wine stain

Before and after photo of child’s face after treatment with pulsed dye laser for capillary malformation, or port wine stain.

daughter hugging her mom around the neck

Treating Capillary Malformation

When performed by an expert, laser therapy is the preferred choice of treatment and can be safe and effective. Dr. Panossian uses the pulsed-dye laser (PDL) as his laser of choice. Laser therapy can be quite painful, despite use of topical anesthetic application (eg, EMLA). Also, in very young children or in large areas of treatment, Dr. Panossian recommends performing laser therapy under general anesthesia or sedation for both comfort and safety. This is especially true for capillary malformations involving areas close to the eyes. Recent scientific evidence suggests application of laser therapy at a very young age in order to take advantage of favorable skin characteristics of infants and the relatively “shallow” location of the capillary malformation. Multiple sessions or treatments are expected, each between 2 and 6 weeks apart. This schedule is critical in obtaining the best results in the fewest number of treatments.

A common misconception is that lasers can virtually eliminate all traces of these lesions. Not true! As a general rule, the darker the malformation or skin blemish, the deeper the lesions extend into the skin. The deeper the penetration into the skin, the more difficult it is for lasers to reach the base of the colored mark to remove it. The result is multiple rounds of laser therapy with little or no improvement. In addition, aggressive laser therapy can result in permanent scarring.

Dr. Panossian’s breadth of knowledge in this field allows his patients to confidently see results without enduring repetitive and costly treatments. He has also dealt extensively with complications related to burns and scarring from aggressive laser use.

Why Choose Dr. Panossian?

He received his medical education at Tufts University School of Medicine.
Graduated at the top of his class at UCLA, receiving Phi Beta Kappa and Summa Cum Laude honors.
Was accepted into an elite combined general surgery and plastic surgery residency at the Keck School of Medicine of USC.
Completed subspecialty training in craniofacial surgery at the Hospital for Sick Children in Toronto and Harvard Medical School.
Was mentored by Dr. Ron Zuker in the practice of facial paralysis reconstruction. This prestigious fellowship position was available to only one surgeon in the United States.
Is a member of the American Society of Plastic Surgeons and the highly selective American Association of Plastic Surgeons, reserved for only a select group of individuals nationally who have demonstrated excellence in academic plastic surgery.
Is affiliated with various charitable and educational organizations, including Operation Smile and Mending Kids.
Holds memberships in several other professional societies including the American College of Surgeons and the American Society of Reconstructive Microsurgery.
He serves on the Board of Directors for Mending Kids and the Gondobay Manga Foundation, a non-profit organization dedicated to the improvement of lives in Sierra Leone.
Has been nominated by his peers annually since 2012 as a “Super Doctor.”
Served as an expert medical consultant and appeared on The Doctors, Grey’s Anatomy, and Nip/Tuck.
Has been featured as “Top Doctor” in US News and World Report, Pasadena Magazine, and Los Angeles Magazine.

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"Dr. Andre Panossian is a superlative plastic surgeon and a very helpful and pleasant individual. He handled a complex surgical problem and achieved a result that exceeded expectations. I would recommend him to anyone."

- J.M.