The most common plastic surgery-related congenital conditions of the lower extremity are: constriction ring, lymphedema, syndactyly, nevi, and vascular anomalies. Principles of reconstruction are based on the condition and type of deformity. The pediatric population typically has less co-morbidities than adults that can negatively affect outcomes (eg, diabetes, peripheral vascular disease), although children can be less compliant with postoperative care. Growth, development, appearance, and postoperative compliance are variables that especially influence operative management of children.