Management of Adult Facial Vascular Anomalies

This document from 2003 discusses the management of adult facial vascular anomalies, including hemangiomas and vascular malformations. Treatment options include laser photocoagulation, sclerotherapy, embolization, and direct surgical excision, but therapy is often only palliative. Patients should be advised of the limitations of each treatment option to avoid unrealistic expectations and disappointing results. Laser treatment is considered to be the treatment of choice for capillary vascular malformations, but multiple treatments are needed to achieve maximum benefit. Venous malformations are usually unresponsive to the pulsed yellow dye laser, but may be treated with other lasers such as the diode laser or continuous-wave lasers. Surgical debulking is difficult for lymphatic and venolymphatic malformations due to the fibrotic consistency that obliterates natural tissue planes. Treatment should be tailored to the individual patient, and options include conservative observation, highly selective embolization of the smallest feeding arteries, and complete surgical excision.