A NONPROFIT IN CARLSBAD IS HELPING RESHAPE THE FACES AND LIVES OF CHILDREN HERE AND AROUND
THE WORLD. FRESH START OFFERS FREE RECONSTRUCTIVE SURGERY FOR THOSE WITH DID HE FORM AT THISES
AS WELL AS ACCIDENTS AND ABUSE VICTIMS. DUANE BRUN SPOKE WITH THE PLASTIC SURGEON WHO MADE
A COMMITMENT TO HELPING THOSE YOUNGSTERS.
PLASTIC SURGERY ARE COSMETIC PLASTIC SURGERY IS SOMETHING WE THINK ABOUT FOR THE RICH AND
FAMOUS OR BABY BOOMERS OR OLDER ADULTS WHO WANT A LITTLE IN MY NIP AND TUCK. YOU HAVE
WORKED ON CHILDREN FOR QUITE A WHILE. WHAT PICTURE COMES TO MIND WHEN YOU THINK ABOUT
A CHILD YOU HELPED GET A FRESH START?
PROBABLY ONE OF THE MOST REMARKABLE PATIENT EXPERIENCES I HAVE HAD HAS BEEN WITH A YOUNG
LADY AT RAINY CHILDRENS, NATALIA LET'S CALL HER FOR PRIVACY SAKE. SHE WAS ABOUT 16 YEARS
OLD AND WAS BORN WITH A VERY UNUSUAL CLEFTING SYNDROME, NOT WHAT YOU THINK OF AS A LITTLE
CLEFT LIP BUT IN UTERO AS SHE WAS DEVELOPING THERE ARE THESE BANDS THAT SOMETIMES FORM
IN THE APPLE KNOT I CAN FLUID AND LITERALLY SLICE THROUGH FETAL TISSUE, SO SHE WAS LEFT
WITH SAY ONE EYE THAT WAS MISSING, AND-A-HALF A NOSE AND A LIP CUT THROUGH SO VERY, VERY
SERIOUS AND VERY DEFORMING CONDITION. SHE HAD HAD PROBABLY 40 OPERATIONS BY THE TIME
I MET HER, AND HE WE REALLY DID A MORE DEFINITIVE OPERATION BRINGING HER EYES TOGETHER, REBUILDING
HER NOSE, MOVING HER JAW, BUT BEFORE SHE HAS SURGERY WHAT SHE DOES IS HAS US TURN ALL THE
OPERATING --ALL THE LIGHTS OFF IN THE OPERATING ROOM EXCEPT FOR THE MAIN LIGHTS, AND SHE PUTS
ON AN AZTEC DANCE, AND SHE THEN KNEELS BY THE TABLE, SAYS A PRAYER FOR EVERYONE IN THE
ROOM INCLUDING HERSELF, HOPS UP ON THE TABLE AND THE LIGHTS GO BACK ON AND SHE GOES TO
SLEEP. IT IS ALMOST MAGICAL TO WATCH THIS AND KIND OF IMAGINE ALMOST THIS SLOW MOTION
DANCE THAT SHE DOES JUST BEFORE SHE SAYS HER PRAYER. I GUESS PEOPLE LIKE NATALIE ARE THE
KINDS OF REASONS THAT I LIKE TO BE INVOLVED IN TREATING CHILDREN AND YOUNG ADULTS AND
ADULTS THAT HAVE SEVERE DEFORM DEFORMITIES.
I HAVE SEEN THE BEFORE AND AFTER PICTURES AND PEOPLE OFTEN JUDGE EACH OTHER BASED ON
WHAT THEY LOOK LIKE. WHY IS IT IMPORTANT THAT THESE YOUNG PEOPLE WHO HAVE NOT ONLY DID HE
DEFORMTIES OR MAYBE ABUSE AS A CHILD, WHY IS IT SO IMPORTANT THEY GET HELP?
VIRTUALLY 95% OF THESE CHILDREN HAVE NORMAL BRAIN FUNCTION. THEY'RE NORMAL KIDS. THE WAY
SOCIETY RESPONDS TO A HORRENDOUS DEFECT, HOWEVER, IT IS NOT SOCIETY'S FAULT, YOU KNOW. WE ABHORE
SOMETHING THAT IS THAT SAD LOOKING OR THAT DEFORMED, SO I THINK IN LARGE MEASURE THESE
CHILDREN ARE STRIVING JUST TO BECOME ACCEPTED PARTS OF SOCIETY. THEY'RE STRIVING TO BE TREATED
NORMALLY RATHER THAN SHIED AWAY FROM. THEY WANT TO BE TALKED TO THE SAME WAY YOU AND
I WANT BE TO TALKED TO.
DR. COEN, I AM ALSO FASCINATED BY THE FACT THAT NOT ONLY ARE YOU A SURGEON BUT YOU ARE
AN ARTIST, A PAINTER AND A SCULPTOR. HOW DO YOU SEE ART INTERSECTING WITH THE SURGERY?
WELL, I MADE A GOOD CHOICE AS A PLASTIC SURGEON. IT INTERSECTS A DAILY BASIS. FOR ME IT IS
VERY NATURAL AS AN ARTIST BECAUSE I LOOK AT IT WITH AN ARTISTIC EYE. IF IT LOOKS PROPORTIONAL,
IF IT IS IN BALANCE, YOU KNOW, THOSE ARE THE THINGS THAT WE SEE. AS AN ARTIST I OFTEN RESPOND
MORE TO THOSE NUANCES RATHER THAN MATHEMATICAL FORMULAS.
THE PROGRAM FRESH START SERVES ABOUT 1,300 CHILDREN A YEAR.
YES.
DONATES UP TO A MILLION DOLLARS WORTH OF SURGERIES.
YES.
HOW MUCH DOES A TYPICAL SURGERY COST AND HOW LONG DOES A PATIENT SPEND IN THE PROGRAM?
ONCE WE INCORPORATE THEM AS A PATIENT, THEY'RE SEEN ON A REGULAR BASIS. THEY'RE FLOWN BACK
TO SAN DIEGO ON A REGULAR BASIS, AND THEY'RE TREATED THE SAME WAY A CHILD IN THE UNITED
STATES WITH INSURANCE WOULD BE TREATED. AND THEN IN TERMS OF COSTS, THESE PROCEDURES CAN
RANGE FROM OPERATIONS THAT IF THEY WERE IN THE HOSPITAL AND IN AN INTENSIVE CARE UNIT
FOR A COUPLE OF DAYS, THEY COULD RANGE IN PRICE FROM SAY 50,000, 60,000, $100,000 MAYBE
DOWN TO $5000 FOR A MORE MINOR OUTPATIENT PROCEDURE.
WHY ARE YOU SO COMMITTED?
I AM COMMITTED TO THESE CHILDREN BECAUSE MAKING THEM HAPPY AND IMPROVING THEIR LIVES IMPROVES
MY LIFE, MAKES ME HAPPY. WHEN YOU SEE A CHILD BLOSSOM BECAUSE THEY'RE MORE COMFORTABLE WITH
THEIR APPEARANCE AND THEY'RE BETTER ACCEPTED AMONG THEIR PEERS, IT IS HARD TO GET A BETTER
FEELING THAN THAT. I JUST DON'T SEE ANY THING THAT WOULD BE BETTER THAN THAT TYPE OF CHARITY.
DR. STEVEN COEN HEADS THE CRANIAL FACIAL CENTER AT RAINY CHILDREN'S HOSPITAL AND NOW HAS 800
SURGERIES A YEAR REGARDLESS OF FAMILY'S ABILITY TO PAY.