6 months old with nevus of left arm and hand
At age 4 Scarlett underwent a three stage surgery to remove most of the birthmark from her left arm and replace it with normal skin from her abdomen. The first stage of the surgery was placing a large tissue expander in her left lower abdomen. This stayed in place and was filled for 14 weeks. The new skin that was gained by tissue expansion was then used to replace the skin on her arm when the mole was removed.
Abdominal tissue expander completely filled. Shown just prior to removal of nevus and attachment of abdominal skin to arm.
Arm attached to abdomen for 3 weeks.
The second stage of the surgery involves removing the tissue expander and excising the nevus from the arm. The arm is then placed into a tunnel below the abdominal skin and sewn into place on the abdomen. This allows the blood supply from the arm to begin feeding he abdominal skin. Over three weeks the skin grows onto the arm and can survive once the skin is detached from the abdomen in the third stage of the surgery.
Arm separated from abdomen with new skin.
Four weeks after separating the arm from the abdomen, scars still healing!
More surgery will be needed to fully remove the remaining nevus on the hand.