Surgery worth smiling about

2013-06-02 14:00

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Thabiso Dyani (14) lost her smile six years ago. After a dog bite mangled her face, she was left with a web of raised scars on her cheek and almost complete facial paralysis.

She had a littlel movement in her eyebrows, but when she tried to smile, her features would arrange themselves into a lopsided frown.

Because of a surgical procedure organised by the Smile Foundation, Thabiso will soon be able to smile once again. Thabiso is one of three children in South Africa this week who has received facial reanimation surgery for the organisation’s Smile Week.

When City Press visits Thabiso in the children’s ward at Charlotte Maxeke Johannesburg Academic Hospital, she was fast asleep. She was wearing a red robe provided to her by the Smile Foundation, and stuffed animals were arranged at her feet. Her mother Tembela sat at her bedside, gently rubbing her arm.

“She was so terrible,” Tembela says of her daughter’s condition after the dog attack. “During that time, we were alone. We didn’t have money and didn’t have anything. And my child was like that,” she said.

Now, she says, all she wants is for her daughter to regain her smile.

When Thabiso eventually opened her eyes, she talked about how she was teased at school for her “side that doesn’t work”. “People would laugh at me.

When I found out I could get my smile fixed, I was happy. I’m going to feel normal,” she said.

To prove to people she was happy without being able to smile, Thabiso said she would always try to hold in her tears. When she is asked about her age, Thabiso says she is 15. “What?” her mom laughs. “She is 14. Thabiso, because you were born in June doesn’t mean you are 15 now,” she says.

Professor George Psaras is one of only a few surgeons around the world with the specialised skills to operate on a case as complicated as Thabiso’s.

He headed the first all-South African team to operate on a facial reanimation case 11 years ago. Now he returns to South Africa from Cypress twice a year to operate during Smile Week.

Psaras said: “By doing this transplant, you’re basically allowing them to smile, which is quite important in day to day relationships. If you talk to somebody and tell them a joke, and they just look at you with a blank face, you would think this person was stupid.”

The microsurgical procedure can take up to 12 hours in the operating room and involves transplanting tissue from one part of the body to another.

In Thabiso’s case, a segment of muscle was taken from her thigh. The artery and vein from the thigh muscle is connected to the original damaged nerve in the face. The transplanted nerve from the thigh takes about three months to grow into the facial nerve. Ultimately, patients are able to produce the notion of a smile.

“I have yet to see a child that was reluctant to have the surgery knowing it would help improve their appearance,” said Psaras. He sees a wide range of cases. Some have complete facial paralysis and some only partial. Some patients are born with the neurological disorder Moebius Syndome that causes facial paralysis from birth. These children tend to have mask-like faces and often wonder why they are different.

“Other kids start to tease them. Sometimes they complain to their parents and say ‘What is happening to me and why am I like this?’”

Even though this Smile Week focused on facial reanimation surgeries, the Smile Foundation provides free corrective surgery to any child in South Africa with a facial abnormality. This includes children with cleft lips or palates and burn victims. As long as the family is not on medical aid, patients in need will be seen at one of the seven academic hospitals throughout South Africa that the organisation works with.

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