News & Features


Facial Rejuvenation

Breaking the Cycle of Abuse


By Andrew A. Jacono, M.D. F.A.C.S.

CONSUMER BRIEF: Every October is marked as National Domestic Violence Awareness Month. One of the leading programs in the United States for helping women break the cycle of domestic abuse is FACE TO FACE. Sponsored by surgeon members of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), the program helps women by providing free facial rejuvenation and reconstruction to battered faces.

Melissa, a 42-year-old mother of two and a Nassau County, New York, resident suffered battering at the hands of her abuser for 17 years. The abuse had literally flattened her nose. The blows also caused facial tendons to loosen from her lower eyelids, which then drooped. Moreover, her breathing was severely restricted.

(Melissa agreed to be photographed and interviewed but requested that her last name not be used for fear of retribution by her former partner.)

Finally, after two particularly brutal beatings in August, 2007, Melissa sought help from a hotline operated by Nassau County Coalition Against Domestic Violence. Eventually, she was sent to see me under the FACE TO FACE program for a facial reconstruction evaluation.

Costs of Plastic Surgery

Melissa said she had never considered surgery because of its high cost and because "there was always something more important that my kids needed."

She also said her partner often aimed his blows at her face, threatening, "When I'm done with you, no one else will ever want you!"

In a six hour operation at Long Island Jewish Medical Center, I rebuilt Melissa's nose, repaired her lower eyelids and some damaged tendons at the corner of her eye. The operation involved 12 other hospital staffers so the total cost would have been about $40,000 if she had been paying for it. But all costs were covered by the FACE TO FACE program.

I first became interested in FACE TO FACE after performing facial surgery on a woman who first told me she was in a car wreck. But a few months later, I found she was actually a domestic abuse victim when she returned and I saw that her facial rejuvenation had been totally destroyed in yet another beating. That's why we perform surgery on the faces of battering victims only after they are out of abusive relationships.

Facial Rejuvenation After Domestic Violence Before and After Images

Melissa's profile is pictured on the left, before surgery. She had damage to and in the middle and tip of her nose, her eyelids and at the corner of her eye. Dr. Jacono harvested a two-inch long section of skull bone and, along with cartilage from her ear, rebuilt Melissa's nose. (Skull bone regrows.) Her drooping eyelids were also repaired.
(Photos, courtesy of Dr. Jacono.)


As for Melissa, when her new face was revealed, she said "Now, I can look in the mirror without the constant reminder of an ugly past."

Melissa has made huge strides. She left the abusive partner, has her own apartment, is looking for a job and thinking about going back to school.

But there are many more victims like her.

Domestic Violence

Domestic violence has long been a problem in our society, but one that has also long been swept under the rug. "Domestic Violence is Rampant," says Mindy Perlmutter, Director of Education for the Nassau County Coalition Against Domestic Violence. "It cuts across all class lines and occurs in approximately 15% of the population."

Domestic violence is a pattern of coercion that can include repeated battering and injury, psychological abuse, sexual assault, progressive social isolation, deprivation and intimidation.

Consider these sobering statistics:

  • Over five million women a year are affected by domestic violence in the United States; over one million victims require medical attention.
  • In the United States, a woman is beaten every nine seconds by an intimate or former partner.
  • 75 percent of women who are in an abusive relationship receive battering to their face and head areas.
  • Women who leave their batterers are at a 75 percent greater risk of severe injury or death than those who stay.
  • 42 percent of murdered women in the United States are killed by their intimate partners.

Plastic Surgeons Help

FACE TO FACE surgeons make sure that the woman is helped emotionally as well as physically. After the psychological healing has begun (with the help of professional counseling) and the victim is safely away from the violent relationship, surgery is performed to repair damaged facial features and, hopefully, alleviate the painful memories and reminders of past abuse.

Plastic surgery can help restore these victims physically and allow them to move forward. But plastic surgery is expensive, and for many women who leave their spouses, just having enough money to feed their children can be overwhelming.

Each year for the past four years, the American Academy of Facial Plastic and Reconstructive Surgery Society sponsors "About Face: Making Changes" to raise money for this very worthy cause. I underwrite the cost of the entire evening so the proceeds go directly to the organizations to further their programs. I also donate.

FACE TO FACE has performed over 2000 surgeries since its inception in 1992. Before surgery, the patient must be completely removed from the abusive situation, and second, she must have undergone therapy to help deal with the psychological wounds that are reopened with the trauma of surgery.

As much as I enjoy performing cosmetic plastic surgery, I get no greater gratification than when I see a woman who has been disfigured by domestic violence look into the mirror for the first time and see that the scars of the past have been erased.

Andrew A. Jacono, MD, FACS of The New York Center for Facial Plastic and Laser Surgery in Great Neck and Manhattan is the National Chairman of the FACE TO FACE Committee of the American Academy of Facial Plastic and Reconstructive Surgery. FACE TO FACE is the first surgical group to take a firm stand against domestic violence. 275 AAFPRS members nationwide are helping victims to break out of the cycle of abuse, enhance their self-esteem and begin to rebuild their lives. Dr. Jacono has performed about 10 pro-bono surgeries every year for the last six years and donates 10 percent of the proceeds of his book, "Face the Facts: the Truth about Facial Plastic Surgery Procedures That Do and Don't Work."




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