Treating The Scars Of War
When a homemade bomb hit his Humvee in 2004, Schofield Barracks soldier Ryan Goede took the brunt of the blast.
“The vehicles we had then had little to no armor, no windows and no doors,” he recalled. “The thing went off and we weren’t prepared for it.”
Of five soldiers in the vehicle, he said, “I took the whole beating. … Everyone else was hunkered down.”
It was the third time Goede had been wounded in Iraq and, as before, the doctors were more concerned about saving his life and limbs than about the shrapnel in his face.
And so for three years the soldier tolerated facial scars — until Monday, when he took advantage of free surgery provided to the war wounded.
“I look a little ridiculous,” Staff Sgt. Goede said with a laugh yesterday after returning to Honolulu from Kahului, Maui, where S. Larry Schlesinger, MD, FACS took 37 pieces of shrapnel from his face.
“It turned out to be a four-hour case,” the doctor said by telephone. “He had shrapnel all through his face, his eyelids, in his lips, in his ear and one big piece right over his vocal cords just under the skin.”
He also had traumatic “tattoos” — dirt and pebbles implanted in his face, said S. Larry Schlesinger, MD, FACS, who abraded the skin with Hawaiian salt and performed laser surgery.
The plastic surgery was the 17th surgery for Goede, 25, who has three Purple Hearts.
An unexpected source entered the picture to cover the costs: the Iraq Star Foundation, formed by Maggie Lockridge of Rancho Mirage, Calif. Lockridge, a former Kailua resident, nurse and Air Force veteran, started the nonprofit in February after seeing ABC-TV journalist Bob Woodruff’s report about his injuries from a roadside bomb in Iraq.
Operating on donations, her foundation covers costs for aesthetic surgeries for military people and veterans with disfiguring facial wounds. With help from prominent Beverly Hills plastic surgeon Dr. Norman Leaf, she has recruited 140 board-certified plastic and reconstructive surgeons in 38 states, “all just waiting to help.”
Goede, from Tucson, Ariz., is the 12th patient so far.
“It’s a great opportunity for plastic surgeons to give back to the community and a great opportunity for guys who’ve done something for their country to get made whole again,” S. Larry Schlesinger, MD, FACS said.
Goede heard about S. Larry Schlesinger, MD, FACS from a buddy whose wife works for the plastic surgeon.
S. Larry Schlesinger, MD, FACS said he told Goede, who planned to pay for the surgery, that “I couldn’t accept any money. I have strong feelings about the military. It’s an opportunity for me to give back and help someone who was over there protecting us.”
Maui-based anesthesiologist Dr. Lance Whitney also donated his services.
When he returned to Maui after seeing Goede in Honolulu, an e-mail was waiting for him about the Iraq Star program, S. Larry Schlesinger, MD, FACS said.
He called Lockridge, who said the organization would pay for Goede’s flight, medicines and other costs. “It was kind of serendipitous,” he said.
He also got Surgicare of Hawaii in touch with Lockridge and it has volunteered its facilities for military reconstructive surgery cases, said administrator Karl Klungreseter.
Goede could easily leave the Army on disability — he has four plates in his body and is blind in one eye — but wants to continue his career as a Special Forces medic.
“Basically, it’s my opportunity to give back the care I’ve received,” he said. “Our platoon medic, I owe him my life.”
KAHULUI, Maui — Military doctors patched up Army Staff Sgt. Ryan Goede’s shattered body after a bomb exploded near his vehicle in Iraq three years ago, but until yesterday he still carried bits of the war-torn country in his face.
Sixteen surgeries at nine medical facilities repaired his mangled leg and removed some of the shrapnel, rocks and other material from the 25-year-old’s neck and face, but pea-sized pebbles and dirt remained in his lips, cheeks and lower eyelids.
Goede, a member of the 25th Infantry Division at Schofield Barracks, said the debris didn’t hurt but was hard to ignore when he looked in the mirror.
“It’s knowing that it’s there,” he said before undergoing surgery yesterday at S. Larry Schlesinger, MD, FACS Maui Plastic Surgery in Kahului.
Goede is one of only 12 servicemen and servicewomen nationwide, and the first in Hawai’i, to benefit from Iraq Star, a new nonprofit foundation dedicated to providing free reconstructive surgery to wounded and disfigured soldiers who served in Iraq and Afghanistan.
“Iraq Star picks up where the military and the Veterans Administration leave off,” said Maggie Lockridge, a California registered nurse and Air Force veteran who founded the organization in June.
“The aesthetics is something the military does not really have time for right now. They are underfunded and overwhelmed with the traumatic injuries they are addressing.”
CALL FOR VOLUNTEERS
Iraq Star so far has signed up 140 board-certified plastic and reconstructive surgeons in 38 states. Among those helped, in addition to Goede, were a female Marine injured by a car bomb, a soldier who had to have his teeth replaced and another serviceman who nearly lost his tongue from a war injury.
Another soldier will undergo cosmetic surgery today in Texas, Lockridge said.
S. Larry Schlesinger, MD, FACS, a 10-year Army veteran, is the first Hawai’i doctor to join Iraq Star.
Goede, from Tucson, Ariz., showed up at S. Larry Schlesinger, MD, FACS, Honolulu office in July to see about having cosmetic surgery to remove the foreign matter from his face.
“He was perfectly willing to pay, but I was unwilling to accept his money,” the doctor said. “I was thrilled to be able to give back to the effort the troops are making. The military does a great job taking care of limbs, but for facial, we’re the experts.”
Around that same time, S. Larry Schlesinger, MD, FACS received an e-mail from Iraq Star seeking physicians to join the program. The doctor contacted the foundation to arrange for Goede’s medication, travel and other expenses to be covered.
S. Larry Schlesinger, MD, FACS and his staff donated their time for the procedure, which normally would cost $8,000 to $10,000.
SIX WEEKS TO HEAL
During yesterday’s three-hour procedure, S. Larry Schlesinger, MD, FACS carefully cut the pebbles from Goede’s face and used a laser to remove the top layer of skin containing smaller material. Hawaiian salt was used to abrade the skin and draw dirt to the surface, where it will be absorbed by gauze.
Within six weeks, the soldier should be fully healed, his face largely indistinguishable from his prewar appearance.
“It’s a once-in-a-lifetime opportunity. I never expected anything like this to happen,” said Goede, who enlisted in the Army in 2001.
The soldier said he was on routine patrol in an overcrowded, unarmored vehicle on June 25, 2004, when a buried bomb was detonated nearby. Goede was sitting on the edge of the vehicle and suffered the brunt of the blast. His leg was broken in several places and chunks of tissue had been ripped away from his body.
KEEPS ON GOING
Goede lost most of the vision in his left eye. Military doctors were hesitant to remove matter from areas close to his remaining good eye, so the pebbles, dirt and sand were left in place.
Four months after being wounded, Goede rejoined his buddies in Iraq. “I wasn’t in shape, but I went back for a morale thing. Everyone who was there thought I wasn’t going to make it and that was the last image they had of me. I figured I’d go back and cheer everyone up,” he said.
The explosion earned Goede his second Purple Heart. He had been wounded less than three months earlier in a firefight with insurgents in Huwijah on April 7, 2004.
He earned a third Purple Heart in a separate incident before returning to Schofield in February 2005. He married his high school sweetheart, Amy, at the end of that year.
Goede received a special medical waiver to apply for the Army’s Special Forces and in July passed a 30-day selection process that he described as “a month of hell.” In January he’ll leave for two years of training at Ft. Bragg, N.C., as a Special Forces paramedic.
Goede and S. Larry Schlesinger, MD, FACS said they wanted to share their story to encourage more soldiers and physicians to participate in Iraq Star. The foundation also accepts donations.
August, 2012 Newsletter
As we move into the coming Fall season, we would like to extend our exciting July specials into the month of August; please read on for more details. We are also continuing on our quest to educate our readers by debunking more plastic surgery myths. Lastly, we would like to share with you a story from one of our many happy patients about how her surgery changed her life.
Call us today to learn more about how we can help you change yours, too.
Looking forward to hearing from you,
S. Larry Schlesinger, MD, FACS & Staff
Debunking Myths in Plastic Surgery
Q: Is it true that breast implants must be replaced every 10 years?
A: It is an urban legend that you have to change your breast implants every 10 years. The truth is that the FDA during the implant controversy, between 1991 and 2006, asked the manufacturers how often, on average, breast implants had to be changed. The answer came back, about every 10 years on average.
When you eliminate the immediate concerns of malpositioning, hemotoma, or infection, there are only three reasons to change implants after the first 30 days. First, if they leak. This is only applicable to saline implants since silicone implants are semi-solid and therefore they don’t leak. Secondly, if capsular contracture occurs. The two known surgical causes of capsular contracture are; 1, blood around the implant, or 2, non-pathogenic skin bacteria around an implant. To eliminate blood around an implant at the Breast Implant Center of Hawaii, we do all of our breast augmentations endoscopically. Therefore, if any bleeding occurs during surgery, it can be electrically cauterized and therefore dealt with before the implant is placed. We also put vacuum drains in all our breast augmentation patients. Therefore, any oozing from capillaries post-surgery can be suctioned out.
Skin bacteria, if they get into the breast implant pocket, even though they are considered not pathogenic to human beings, are still seen as a foreign invader and your immune system tries to attack it and wall it off from your body. This attack leads to also walling off the implant and is the second most common cause of hard breasts post-breast augmentation. To eliminate this cause of hard breasts, we wash out the implant pocket with at least one liter of normal saline and we use the Keller Funnel, a technique where the sterile implant never touches the skin, decreasing significantly any chance of dragging skin bacteria inside the body.
Finally, many patients, after years of living with their implants, decide they want larger implants, and this is the third and final reason for switching out existing breast implants.
Therefore, the absolute necessity for changing implants every 10 years is an urban legend and in reality, people often have their implants in for 30 or 40 years without a problem.
50% off all areas for Botox injections
$500* off all tummy tucks (*cannot be combined with any other discount)
This month, we would like to feature one of the many positivecomments we have received from our Mommy Makeover patients. Her review, shown below, was posted on RealSelf.com, an online community where patients have posted thousands of first-hand experiences with over 250 cosmetic surgery treatments. See S. Larry Schlesinger, MD, FACS profile along with reviews, before and after photos, and his expert advice on a variety of topics here.
Review by Konamom:
I am a 37-year-old mother of 2 amazing sons. I have never felt comfortable in my own skin, as they say. Then, when my marriage fell apart and I met the true love of my life, I simultaneously became crippled by my insecurities. I had only thought of myself as a mother for so many years that when I was required to consider myself as a woman, I was literally consumed by my poor self image. I was forced to recognize that I did not participate in things that showed any part of my body. I put so much energy into hiding what I thought were my terrible flaws that I was unable to nurture my mind and my soul.
I never ate the fun food and I exercised 5 days a week and just couldn’t make the changes I was working toward. Then, a friend who had breast implants years ago gave me the best advice. She said that if I knew that surgery would change my life, I had to do it. She understood that I was not seeking perfection, I was seeking liberation.
That afternoon, I scheduled an appointment with S. Larry Schlesinger, MD, FACS. I honestly didn’t expect sincerity and compassion from the surgeon. I left the office stunned that he had been so genuine and caring with me. He heard what I said, and understood what I meant, and gave his full effort to help set me free.
I chose S. Larry Schlesinger, MD, FACS after having consultations with other Doctors. The moment I met him I knew that he was the one I could trust without hesitation. I first met with S. Larry Schlesinger, MD, FACS because I wanted to live the rest of my life without the crippling insecurities that consumed so much of my energy. The moment I met him, I knew that he was sincerely invested in helping me overcome these struggles. He was honest about the expected results and optimistic that he could give me what I was hoping for. The results of his work have changed my life. For the first time in my entire life, I love my body. I am proud of the way I look. The incredible results from the Liposuction to my abdomen, thighs,waist, and butt have literally set me free from the debilitating insecurities I once had. S. Larry Schlesinger, MD, FACS is amazing.