4th Medical Trip of American Facial Plastic Reconstructive Surgeons

From October 2nd to 8th 2024, the fourth medical trip of facial plastic reconstructive surgeons from the United States successfully took place in Lviv, in collaboration with Razom for Ukraine and INgenius.

Preparations for the mission began in the spring of 2024 and lasted over four months. During the patient selection process, nearly 100 applications were reviewed, and 35 of the most complex cases were chosen for reconstructive surgeries. Some of these patients were scheduled for surgery in May 2025.

A total of 19 soldiers with serious defects of the ocular and frontal areas, midface area, significant damages of the soft tissues, nasal bones and oral cavity were successfully operated on.

Some of the patients received implants to replace bone defects, including expensive highly technological patient-specific titanium 3D implants, produced and donated by Materialise. All surgeries and consultations for the mission participants were provided free of charge. Ukrainian surgeons, anesthesiologists, and nurses worked for seven days together with the American medical team.

The following procedures were performed:

Nasal reconstruction with a free forehead flap on a vascular pedicle – 7
Placement of the PSI (patient-specific titanium 3D implant) – 3
Commissuroplasty – 3
Placement of spherical orbital implants made of porous polyethylene (Medpor) – 5
Orbital floor/rim repair with titanium/porous polyethylene implants – 3
Eyelid reconstructions – 10
Upper lid gold weight placement for the correction of paralytic lagophthalmos – 2
Midface lift – 3

Additionally, there were scar revisions, canthoplasties, upper and lower eyelid fornix reconstructions, eviscerations, placements of ocular prostheses, lip reconstruction, cranioplasty, fat grafting for cheek tissues, and other operations.

It is also important to emphasize the significance of the training provided to Ukrainian specialists during the mission. The goal of the American team was not only to help severely wounded soldiers but also to pass on their experience to Ukrainian doctors. Therefore, even after this team work, the skills acquired can be applied to treat other complex patients.

Moreover, all operated patients will continue to be monitored by Ukrainian doctors, who will report on their condition to the American colleagues, which will allow the optimization of the recovery processes.

Some patients will undergo further stages of surgery and, if necessary, will have the opportunity to seek help from American doctors during the future missions.

The first week of October was highly productive for the mission team and successful for our patients.

This mission was unique: originally planned as a large-scale operation, it was scaled down due to recent attacks in the region. In response the determined team of seven, including facial reconstructive and oculoplastic surgeons, adapted to the circumstances and went forward. Despite the challenges, Razom’s team—led by Yuliia Shama, Lilies Dzaliuk and coordinator Nataliya Kuts —mobilized resources, restructured logistics, and ensured the success of this critical mission.

Nataliya Sawka joined the team as safety specialist, and did due diligence with analyzing threats and coordinating safety protocol.

The smaller team found Lviv relatively calm during the week, allowing them to work through a packed schedule of surgeries and consultations. Dr. Parag Gandhi emerged as a leader among the group of oculoplastic surgeons, creating a seamless collaboration with local specialists. Dr. Gandhi gave a talk (remotely) during this mission on Pericular Soft Tissue Reconstruction for a conference Glaucoma+. This exchange allowed Ukrainian and American doctors to share advanced techniques, further strengthening the cohort of Ukrainian surgeons in Lviv who now have the skills to address complex cases independently.

Beyond the operating rooms, Razom equipped local hospitals and shelters with vital supplies, including cots, sleeping bags, water, snacks, and disposable items, ensuring readiness for any future needs.

The Razom team expresses its sincere gratitude to everyone who made this project possible.

We are grateful to:

The team of American surgeons and nurses:

For their invaluable contribution to the health of our servicemen and to the training of Ukrainian doctors.

The team of Ukrainian doctors:

Plastic surgeon Vitaliy Panchenko for his assistance in the implementation of the mission, organizing patient acceptance at his department, and performing surgeries at his hospital.

Also, a special thanks to the highly qualified and organized team of surgeons, anesthesiologists, interns, nurses, and junior medical staff at the Ukrainian hospital who were always ready and worked clearly, professionally, and in harmony.

The members of the INgenius team: Ivanka Nebor, Kyrylo Chuhai, Yelyzaveta Baran, Anna Tovkes, Ihor Solovey, Daryna Chernenko for organizing the patient selection and the high-level performance of the mission.

Materialise Company for the production of 3D implants for our defenders, and also to the volunteers from the company — Anastasia Krychun, Olga Hornyak, and Kateryna Stepura for their assistance in preparing models and their high-quality visualization during the surgeries.