You'll find hundreds of files on cleft lip, cleft palate here on

This one is about: Let Go and Let Doc

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****  LET GO AND LET DOC  ****

Learning to Trust the Doctor to Make Good Choices for our Kids
by Joanne Green

It was Joey who actually decided that it was time he got a "pointy nose". Having been born with a very severe bilateral cleft, with very little tissue to work with and almost no columella at all, his nose was quite flat.

He looked great straight on, but in profile, his lips stuck out further than the end of his nose. In fact, in profile, his nose disappeared. Then one day at clinic the doctors were discussing "potential rhinoplastic intervention . . . . " and asked me for my opinion. I looked at my six-year-old son and said, "What does Joey think? What do you say, son? Would you like to have a pointier nose?"

He looked at me with wonder in his eyes. "You mean," he stammered out, "They can DO that?" Well, he had never mentioned it to me before that because he didn't know that we had any choice in the matter. But on the day he learned that it could be done, a pointier nose is exactly what he wanted And so we started the process to get it done.

That's when I started getting nervous. Change my baby's face? How can they do that? What will he look like? WHAT IF THEY MESS IT UP?!? I tried to calm myself by telling myself that some part of the hippocratic oath must say something about "Do no harm." But what if they don't MEAN to mess up?

Now, there are rhinoplasties and there are rhinoplasties. I've seen some very good ones and I've seen some very bad ones. I've seen nose jobs that make the nose look like a plastic mound above the mouth. Of course, those were the only ones I could remember when it became obvious that my son wanted to change his nose. I had nightmares of Michael Jackson. He has all the money in the world, and he ended up with a nose he could open letters with. Suddenly I could not think of one person whose nose looked good after it was fixed. I shared my concerns with our doctor. He smiled and said, "You know I wouldn't do that."

Time went by. We had to wait a while for a more optimum time. Joey was persistent, and suddenly a new fear gripped me. What if the doctor gives him a European nose? My son is Asian! His nose should be shorter and flatter. The doctor is white, like me. What if the doctor gives him the wrong nose for his ethnicity? Somehow I was never able to quiet that fear.

That Spring I went to a conference where I examined a poster done by a group of Japanese plastic surgeons. They described a technique called the "Flying Bird" that they used in Japan to achieve a natural-looking nose. I gathered the information, feeling quite fortunate that I could share this with my doctor. After all, he may not know about this technique! When I gave him the literature, he just smiled. He also reminded me that there are a number of techniques that could be used.

Time went by. The surgery approached. I just imagined my little boy's face with some big, bulbous nose sticking out there, waiting for him to grow into it.

Why change his face, anyway? I loved that face. What does he need a big old nose for anyway? A lot of people have flat noses, and his was adorable. But HE wanted it done, and the doctor concurred. So I talked his teacher into doing silhouettes of the kids in her class so I would have a permanent record of his adorable little nose.

The doctor sensed my apprehension. He went so far as to draw a diagram of what he was going to do to lengthen the columnella and raise the tip of his nose. All I could say was, "But not too much, right? I mean, he's Asian, you know."

The day came. We prepared for the outpatient surgery. Joey was anticipating the best. I was anticipating anything else. When the doctor came in to take Joey to the operating room, he lifted my baby boy into his arms and let me kiss his sleepy smile good-bye. As he turned to go, I grabbed the doctor's sleeve and said, "Remember - - - he's Asian."

The doctor only smiled.

It was a hard two hours that we waited. I imagined a Roman nose on Joey's tiny baby face. I thought of Carl Maldon and Bob Hope. I thought of kids I'd seen whose noses looked like they belonged on other people's faces. And I thought of Joey. What were they doing to his face? The clocked ticked slowly around and at long last the doctor came out.

"I think we hit a home run." he told me. "Everything went as well as we had expected, and I think you will be very pleased when you see him."

Moments later I was escorted into the recovery area. He was getting stabilized and would soon be in my arms again.

The nurse brought him out. I stared, transfixed. There was a bandage over his lip and sleepy little eyes. And there, between the two, was the nose my son was meant to be born with.

I couldn't stop staring. It was beautiful. It was natural. It fit his face perfectly. And it was Asian. Way to go, Doc! He didn't need my advice at all.

I often wonder why I couldn't just let myself trust that the Doctor knew what he was doing. After all, he had done absolutely beautiful work on all three of my children. In fact, he is the only person in this world that I trust with my children's faces. And for good reason.

It must be a matter of control. I wanted to somehow control the outcome of that surgery. As Joey's mom I couldn't let go and trust that the man I had already learned to trust would do his very best. Did I learn anything from that experience? I hope so. I hope I learned that once my homework is done, and I have selected the doctor who will treat my children, I have to let him treat them. I hope I learned that he is the one with the medical degree and I am the one with the child. I hope I learned that I shouldn't try to be the doctor any more than he tries to be the mother. If I learned all that then I will have gained some wisdom.

But then again, my daughter, Jessica, was also born with a bilateral cleft. Her nose is still flat. Someday she will want a pointy nose, and someday our doctor will give her one. I guess we'll know how much I learned when the time comes.

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