is believed that many cases are so minor that they are taken care of shortly after birth and not reported, so actual statistics may be higher. Positional Plagiocephaly – IN 1992, to decrease the incidence of SIDS, the American Academy of Pediatrics initiated the "Back to Sleep" campaign, which recommended that babies be put to sleep on their backs. While this almost halved the number of SIDS deaths, the campaign appeared to also help raise plagiocephaly incidence fivefold, to roughly one in sixty live births. Plagiocephaly is simply the flattening of one area of the skull, generally one babies tend to favor as they lie. While treatment is often as simply as repositioning the baby during sleep, in more pronounced cases helmet therapy may be put to use. In most cases, plagiocephaly is quite minor and easily resolved, with many more pediatric plastic surgeons becoming familiar with helmet therapy for more advanced cases. Craniosynostosis – Much less common, but potentially much more serious than plagiocephaly is craniosynostosis. Craniosynostosis is a congenital abnormality originating from the central nervous system in which one or more of the fibrous joints in the skull close prematurely. This fusion often requires surgical intervention to reconstruct the skull (see craniofacial surgery) either to bring it back to its normal position or to give it a more natural shape. It is believed that craniosynostosis occurs in 1 out of 1,800 to 2,200 live births, and is often a side effect of an associated syndrome. Cosmetic plastic surgery While the majority of pediatric plastic surgery procedures done are reconstructive; there are those performed for cosmetic purposes. The most common procedures done for cosmetic benefit in children include: Breast augmentation Male breast reduction Ear surgery as a result of microtia Rhinoplasty Out of all procedures, nose reshaping generally has the most cases on an annual basis (4,313 procedures in 1996). However, children make up only 9% of the total caseload for all nose reshaping. On the opposite end of the spectrum, children requiring ear surgery accounted for 2,470 procedures in 1996, a total of 34% of all total ear surgeries. While many of these procedures are done for purely cosmetic benefit, many plastic surgeons work on these features (giving them a more normal appearance), while performing a surgery to improve function as the result of a congenital deformity. Multi-disciplinary emphasis With the unique challenges created in the field of