Because treatment for congenital nevi can often be extensive, Dr. Chariker and Rapp understand the importance of the Surgery Center in establishing a trusting and comfortable relationship with young patients and their parents.Congenital nevi are most commonly present at birth, but in some cases appear between birth and two years of age. The presence of congenital nevi is a known risk factor for the development of more concerning lesions in the future.Congenital nevi are typically raised from the surface of the skin, brown in color and larger in size than common, acquired nevi. They are categorized according to diameter. Small: less than 1.5cm, medium: 1.5-19cm and giant: 20cm or larger. Nevi may also be categorized as small or giant based on their location, or on whether or not it is possible to easily close the area after excision.Because of the extent of the surgery involved with most congenital nevi excisions, dermatologists are not equipped to remove them. Patients are typically referred to a specialist in plastic surgery. We often work closely with dermatologists and pediatricians to decide on which ones and when it is time to perform a biopsy or proceed with complete or staged excision.In many cases, excision of congenital nevi can involve as many as three to four separate procedures. We feel it is important that the treatment occurs in an environment where the children and their families can feel comfortable with familiar professionals. The Surgery Center, with its own dedicated staff and anesthesiology department, makes this environment and these relationships possible.