forensic nurse - About Face: Program Gives Domestic Violence Victims a Fresh Outlook

Once a regional beauty queen, Jane Stanley had a peaceful adolescence, seemingly lifted from a Norman Rockwell painting. But one burgeoning relationship turned her simple life into a hellacious battle for survival.

Stanley’s abuser left her face scarred from frequent beatings. Her eyelids were disfigured from unending black eyes. Her skin sagged and her eyes appeared constantly swollen. Her nose had been broken repeatedly, leaving her with severe facial damage. By the time she got away, Stanley’s appearance was completely altered.

Officials at the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) know that victims of domestic abuse are often left with overwhelming emotional and physical scars. Getting away from an abuser often leaves the victim in a difficult financial situation as well, so that therapy and plastic surgery are usually unobtainable.

AAFPRS became the first surgical organization committed to helping victims of domestic abuse in 1994 with the creation of the Face to Face program.

"The AAFPRS provides a program to survivors of domestic abuse," says academy president Dean M. Toriumi, MD. "After they have reported the incidence to the National Coalition Against Domestic Violence (NCADV), they go through professional counseling. Once they have gone through a period of emotional healing, the NCADV refers them to the AAFPRS who then refers them to a facial plastic surgeon who participates in our program. The surgical fees are waived and the patient can then undergo reconstructive surgery to repair damages to the face."

Stanley can thank insomnia for hearing about the program. Today, the domestic violence advocate works to help inform others about Face to Face, which financed her multiple surgeries and restored her original identity as a woman, rather than a victim.

"I woke up one night when I couldn’t sleep," she explains. "I turned on the television and I heard a woman talking about her scars and the AAFPRS program. I noticed some of her scars were like mine. I got up the next morning and started looking for the program."

Officials at the local women’s shelter had not heard of Face to Face, but a counselor, "Miss Betty," helped Stanley find the program on the Internet. After a year of counseling, Stanley was ready for the first of several surgeries with a nearby plastic surgeon — a member of AAFRPRS.

"I had my upper and lower eyelids done and laser surgery to take care of the scarring," Stanley says. "Lastly, I had nose surgery. I had to have my nose rebuilt with plastic because all of the bones that were broken."

Stanley speaks of her plastic surgeon like an adoring fan. She nearly purrs when she describes how Cynthia Gregg, MD, gave her a new lease on life.

"She is a wonderful and caring doctor," Syanley says. "She is really good at what she does and whatever she would want to do with me would be okay. I trust her that much."

"The program is sponsored by the AAFPRS whose members provide the actual surgical services. It is a service provided directly by our providers to those who have suffered from domestic violence."

Stanley, who says she could never have afforded to pay for such luxury, has created a new life.

"(The surgeries) helped me do a 180-degree turnaround," she says. "It was absolutely wonderful. It gave me more of a backbone than I ever thought about having. I was this little wallflower that wouldn’t do anything and wouldn’t talk to anybody. Then I had the surgeries and it was like, ‘Look out world, here I come!’ Toriumi, who is also in the division of facial plastic and reconstructive surgery in the department of otolaryngology head and neck surgery at the University of Illinois, says Stanley’s surgeries are typical.

"A significant number of women who suffer domestic violence have injuries to their facial region," he says. "The most common procedure would be correction of a facial fracture, such as a nasal fracture. I think patients also frequently undergo revision of scars."

"About 1,250 women have been involved in the program and 275 facial plastic surgeons have participated," he says. "In 2000, the Face to Face help line received about 5,000 new calls."

Before the academy and their surgeons invest in these callers, therapy to help emotional scarring must occur first.

"My responsibility is to make sure patients who have suffered domestic violence are treated effectively," Toriumi says. "The emotional support is provided by professional counselors and is not directly handled through our academy. A prerequisite prior to them undergoing any surgical correction is the professional counseling. We feel that is very important so they can get their life back on track."

"I spoke with Miss Betty, a wonderful counselor at the local shelter," she says. "I started talking to her, but felt that this was my problem — I didn’t need to bring on anyone else. Miss Betty helped me learn that you can talk about it because you can go on with your life. I haven’t stopped talking about it since. It helps you to forgive what you put yourself through and to move on with your life."