Surgery to Remove Cafe Au Lait Birthmark?

Question

I have a cafe au lait birthmark on the right side of my cheek.  Laser treatments did not work for me. Do I need to undergo a surgery? How much will it cost approximately?

Raffy Karamanoukian, MD, FACS · Answer

Café au lait spots can be removed by surgery, but laser is the first line treatment for the birthmarks. Our office performs laser and surgical excision of moles and birthmarks on the face and body. Best, Dr. Karamanoukian

Harold J. Kaplan, MD · Answer

Both laser treatments and surgery are options for your birthmark. We agree with Dr. Rajagopal that q-switched lasers are an excellent option and you should find out what kind of laser was used for your treatments and if it was a 1064 or 755 nm q-switched laser. Just because you did not respond to treatment previously does not mean lasers will not work for you. But you must make sure you are being treated by an experienced practitioner using q-switched lasers. Surgical removal is an option as well and we have done this before in cases where a birthmark reappears repeatedly after laser treatment or does not respond to lasers.

Erik Suh, MD · Answer

I would opt for laser first before surgery.   Q-switch lasers are usually used for these lesions.   Lutronics also offer Spectra laser which costs about $200 to $300 per treatment, and you will probably need about 10 treatments, and retreatment as needed.  It is the same laser that is used to remove tattoos.

Renita (Lourdhurajan) Rajan, MD, DNB · Answer

We are seeing very encouraging results with the Picoway, for Cafe Au Lait Macules. It would be useful to give that a try.Good luck.

Usha Rajagopal, MD · Answer

The best way to remove caf&eacute; au lait birthmarks is through the use of laser treatments. A QS 1064 nm or QS 755 nm laser would be the most effective type of laser for removing a caf&eacute; au lait birthmark. Several treatments are required for birthmark removal. Cost of treatments varies depending on the size of the birthmark. I would suggest asking to do a &ldquo;test spot&rdquo; of the birthmark with your doctor, which means treating a small area of the birthmark first to see how it responds to the laser treatment.

Davin Lim, MBBS, FACD - Account Suspended · Answer

CALMS or cafe au lait macules are
notoriously difficult to predict. 50-60% respond to laser, and if so,  I
would choose the 1064 (or 755 Alex) Q switch laser. Of those that respond 1/3
to one half will recur over time, but can be retreated. With the event of newer
lasers in the PICOSECOND pulse duration, clearance rates maybe higher, studies
are now being undertaken all over the world. We don't really know yet how pico
lasers will work on CALMS.

If you undergo surgery, more than
likely serial excision will be best- you need to discuss with your surgeon what
is best. The scar following surgery can always be lasered.

My suggestion- wait for the pico
studies, as if performed correctly, scarring will be minimal.

Regards

Dr Davin Lim

Brisbane, Australia

Surgery to Remove Cafe Au Lait Birthmark?

Answers (6)

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