Educational Missions


Each year, Plastic Surgery chief residents may elect to participate in educational mission work.

Below is an account of a mission experience from the perspective of Dr. Ashley Boustany during her 5th year residency

UKnow: Plastic Surgery resident reflects on lessons learned from Ecuador mission trip

By Hilary Brown
Link to original UKnow article.

Dr. Ashley Boustany
For plastic surgery resident Dr. Ashley Boustany, spending a week in a hospital in Ecuador working with surgeons and dentist on cleft lips and palates was the best week of her entire residency.

"And after five years of residency," said Boustany with a laugh, "that's really saying something."

Along with pediatric plastic surgeon Dr. James Liau, Boustany traveled to Guayaquil, Ecuador with the Global Smile Foundation, an organization that brings together international teams of specialists to underserved parts of the world to provide comprehensive care for patients born with cleft lips and palates. Over the course of nine days, Dr. Liau and Dr. Boustany worked with teams of surgeons, anesthesiologists, dentists, speech therapists and psychiatrists to correct cleft lips and palates and provide comprehensive cleft care.

"This was my first trip, so in a way I feel like I got more out of it than [the surgeons], from a resident's standpoint," said Boustany. "It was all very supervised, but I got to do a fair amount of the operation. I learned a lot more about the surgery and the patients and comprehensive cleft care. It was a huge opportunity to go do that."

Working in Hospital León Becerra, a children's hospital in the port city of Guayaquil, surgical teams assessed the needs of patients from all over the region and screened them for surgery, dental work or speech therapy. Complications can arise early on, as a child with a cleft lip or palette or both will have a hard time eating or nursing and as a result can be undernourished and underweight.

"A lot of the children are a lot smaller than they would be here," said Boustany. "So even though they are the appropriate age, a lot of them have failure to thrive, which makes the whole thing more complicated. To be a candidate for surgery, they have to be a certain size to make it safe."

Global Smile

The days were long, and the surgeons operated on as many as 15 children in a day. But for Boustany, Liau and the other members of the team, the reactions from parents are worth it. This surgery is life changing for not just the young patients, but for families who struggle to feed and nourish their child. The surgery isn't just for aesthetics; cleft lips and palates can make it difficult to for babies to breathe, eat, drink and speak.

"The parents are used to seeing their child look a certain way, and to see such a drastic change in such a short time, they were very emotional," said Boustany.

While the trip was an educational one for residents such as Dr. Boustany, Dr. Liau cites the invaluable experience that comes with working with doctors from all over the world.

"It's great we have international groups, said Liau. "Every country gets set in the way that they do things, or have a different set of resources or different focus or another way to fix the lip or palette. Some ways work better than others, and that's for us to figure out. But having that variability and having that exposure to different ways of doing the surgery that looks just as good or better, and being open minded about different techniques is a big part of medicine and doing the best for your patients."


Frankie Cianelloe