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One of the main options for a hemangioma which is deforming or in an area where it’s never going to improve even if it shrinks, is excision. For example, you can have a patient who has a large hemangioma on his or her scalp and it can be growing over the first year. That area – even if the hemangioma goes away by itself or shrinks – it’s still going to leave a bald spot with a very big round mark. So instead of waiting, what you do is while the scalp is pliable and the skin really moves around easily, you just cut out the hemangioma. It’s encapsulated – it does not have the risk of bleeding that people think it does and you end up closing that area. Typically, if you do it when they’re young, it’ll heal as though it was never there. If you leave it, the patient has a potential for having cranial defects pushing into the bone, or having a large bald spot which will be much, much more difficult to treat at a later time.
