Healthbeat Segment: Smile Surgery

November 10, 2011 (CHICAGO)

"I am who I am and I was born this way for a reason," said Jade Bergeron.

Bergeron does not have a right ear and a good portion of the right side of her face is paralyzed. So whether she was sad, happy or surprised. It was up to her left side to do most of the communicating. Her lopsided smile aas never complete.

"I would love to be able to smile and feel confidant and to feel normal," said Bergeron.

She already has a surgically implanted system for her hearing loss. Now the college junior was ready to take another dramatic step. She would undergo a procedure called dynamic facial reanimation to bring the right side of her face to life. Bergeron was nervous but confidant about her decision. Her parents were supportive.

"We are not expecting that oh she is gonna come out of it and have the big bright smile," said Brian Bergeron, father. "What we are hoping is that Jade does have a better quality of life."

On May 23rd, the specialized surgery took place. A team of plastic surgeons at North Shore Evanston Hospital performed the 10-hour operation. It was a procedure that can potentially help children, even certain adults with facial paralysis due to illness, trauma or a birth defect.

"What we do is we take a small muscle from the leg and we do transplant it, so to speak, up to the face," said Dr. Jeremy Warner, plastic surgeon, NorthShore University HealthSystem.

Surgeons say the leg muscle won't be missed by Bergeron and along with it they will take a nerve and blood vessels. An incision was made back where the ear would be, and then with very specialized tools and advanced imaging, the muscle and other tissues were hooked up. Then came the painstaking and artful process of figuring out how to get the transplanted muscle to move naturally.

"That involves...pulling up on the stitches and testing them (butt) and looking at her face and seeing how different tension levels and different stitches in different locations affect how things look," said Dr. Mark Sisco, plastic surgeon, NorthShore University HealthSystem.

Then the long and painful recuperation began. Doctors warned her about the swelling and discomfort, but Bergeron admits it was more difficult than she expected. A couple weeks after the surgery, the muscle had to settle in and the wait begins to see if the nerve is sprouting connections. Eight weeks later, Bergeron started to notice a change.

"Even now it's still swollen, but I am starting to see a little bit of movement," said Bergeron.

So why take the risk when your immediate health is not in danger and undergo a complicated surgery to fix a smile?

Dr. Frank Vicari, a craniofacial surgeon at Children's Memorial Hospital, has spent decades fixing the faces of children with mild to severe deformities. He says the psychological benefits are immeasurable.

"Being able to communicate with emotional expression on your face is an amazingly important thing that we probably don think enough about," said Dr. Vicari.

It's now been about 5 1/2 months. The team at NorthShore says the progress is remarkable. Even Bergeon's friends are taken off guard by the change.

"All of a sudden I saw the side of her face move. I was just like oh my gosh your face is moving and I started tearing up and it was amazing that I was seeing this happen," said Samantha Fornino, friend.

Bergeron must practice now using the muscle and working on evening out her smile. It may seem subtle, but Bergeron says its indescribable to experience the thrill of feeling a part of your body come to life.

"Every time just those little changes happen, it's really, really cool," said Bergeron.

Bergeron is expected to continue gaining use on the right side of her face. This surgery is still fairly uncommon but has advanced dramatically in the past five years. Recent research shows it's even more successful now, especially in children. About a dozen centers around the country offer the procedure and NorthShore is now ramping up its program.

NorthShore University HealthSystem

Children's Memorial Hospital

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