Hemifacial Microsomia - Camoflauge Surgeries (Septoplasty/Rhinoplasty, Mandibular Implants) - Bangkok, Thailand

** Please note - the photos I have loaded that...

** Please note - the photos I have loaded that have "before & after" images have been manipulated in Photoshop by me. This is simply me playing around to try to figure out what to expect from surgery, and honestly, to give myself hope. These are not predictions drawn by a surgeon.

I'm going to pretend that this is not a page on the internet, available for everyone to see. I'm going to pretend that this is my personal journal, a place where I can reconcile my thoughts. With that said, where to start? At the beginning, I suppose...

I've been unhappy with my appearance for as long as I can remember, for one reason or another. Teasing in school drew my attention to my freckles, further teasing drew my attention to ears that stuck out, and when I was a little older a boyfriend's mother drew my attention to my crooked nose. I'd always thought it was too big for my face and didn't like it from the side, but I'd never actually noticed it was crooked. From then on, like all the other little things I learned to hate about myself, I couldn't un-notice it. Now, it seems crazy to think that there was ever a time that I didn't notice how crooked my nose is.

As I got to my mid 20s, I was learning to accept certain things about my body. I didn't mind my freckles anymore, couldn't care less about my ears - they didn't really stick out much anyway. I learned to accept my tiny boobs - I think they're even smaller than A cups - and decided that if Kate Moss and Keira Knightly can rock their teeny boobs then so can I! Plus it's easier to find well-fitting clothes, and they won't go all droopy... not for a while, anyway. I didn't even mind my crooked teeth anymore (despite orthodontics in my teen years, one front tooth still overlaps the other).

I had finally gotten to a place where I was relatively happy with the person I saw in the mirror... so long as I was wearing make-up and had my hair done. But there was a problem. Photos. The person in photos never looked like the person in the mirror. She looked awkward at best, and, at worst - ugly, mangled... ridiculous. There was only one angle of my face that I could show in photos and not look terrible - the left side of my face. My nose looked big from this angle but at least it sort of looked straight, and my jaw line looked straight too. Somehow, my teeth looked better from this angle too.

My self-consciousness about my face was constant. no matter where I was, no matter the situation - in the back of my mind I was constantly conscious of my face. Conscious of the fact that everyone to the front or right of me would be looking and wondering why I looked so ugly. Wondering if maybe I'd been in an accident. Maybe they were wondering if I was aware I looked like that. Or maybe, worst of all, they just always knew that I was a reasonably nice, kind of funny, ugly girl. So when they saw me from any angle that wasn't the only one that I'd show to a camera, they weren't surprised. That was just how I looked. This thought horrified me. Still does.

Now, I'm no model, nor do I aspire to be one. I don't want to be on magazines, or be oo'd and aa'd at at parties. I don't want to be the prettiest girl in the room. All I want is to not be the ugliest girl in the room. I want to not be constantly thinking about how I look. I want to laugh and not immediately have an image in my head of a photo I once saw of myself laughing, looking basically, like a mentally disabled person. I want to have confidence when I smile. I want to not cry at the mirror. I want to enjoy having my photo taken, especially seeing as I'm a photographer but have never had a photo shoot myself. I want to go on holidays and take stupid touristy photos, without turning my head to the same side in every single photo, and still end up looking disfigured half the time. I want to, one day, meet a wonderful man and marry him, and look beautiful in my wedding photos, and spend the day focusing on him and not on how I look. I want to not settle for less, as I have in the past, because I believed I deserved less.

So I emailed a surgeon in Perth...

I'm originally from Perth, Australia, but nearly 2 years ago I moved to Phnom Penh, Cambodia. I've been having the time of my life here, doing fulfilling work and being inspired daily by amazing people. But I'm still held back, every day, every moment, by my overwhelming consciousness of how I look. It seems like such a ridiculous waste of energy. It's a terrible waste of precious time, like I'm bound at my wrists and ankles, waiting for my real life to start. I'm surrounded by people, dear friends, who've overcome incredible challenges and injustices in their lives. Daily I see people struggling with the basic necessities of life, and suffering in circumstances that I cannot fathom. I see people filled with faith, a faith that overcomes demons and renews lives. None of it makes me feel better about my face. I feel the same way about my face, and worse about my self as a person for feeling the same way about my face in spite of being showed, vividly, how blessed I am.

Here's the thing: a person's hurt is their own. Perspective is a wonderful thing and I've gained a lot of it during my time in Cambodia. Perspective tells me that my ugly face is a ridiculous and irrelevant thing in the grand scheme of the world. But it's still the same to me, in my little world.

... The surgeon returned my email. Here is a quote from the email:

"This patient has hemifacial microsomia (Facioauricularovertebral spectrum). Nothing can be done to correct her facial asymmetry unless she wants lengthy and multiple procedures to move around her teeth and then her upper and lower jaws. It is possible to camouflage things with a combination of chin and jaw implants and by moving her chin (geniosplasty). The nose and cheeks are impossible to completely correct due to underlying soft tissue deficiency."

Not the happiest email I've received. Of course my next step was to jump on google and search for photos of hemifacial microsomia. What I found was a lot of photos, particularly of young children, with clear examples of the condition. Most of them looked much more severe than me, but it was immediately obvious that I shared the same condition. I could not believe that I hadn't realised it earlier. I was 27 years old and I'd never realised that the whole right side of my face was smaller than the left, that my mouth was twisted to one side of my face, that my jaw line was completely crooked and twisted, and that my middle teeth were nowhere near the middle of my face. I remembered a moment in art class at high school when I was sitting at a table with some girls and we were all light-heartedly teasing each other, and then one of them said to me "at least I don't have a mangled face". Looking at the photos the surgeon had me take, and reading his email response, I finally understood why she had said that.

So, if you've read this far - there it is. The surgeon said it would not be possible to completely correct my condition, but I was never aiming for perfect. My remaining option was to attempt to camouflage the condition. So that's what I want to do now.

I've researched plastic surgeries for years, primarily rhinoplasties. In the past 6 months I've extensively researched hemifacial microsomia and corrective surgeries. There are options, but they are extremely expensive and usually performed over many years as a child grows. As far as camouflaging this particular condition goes, I'm a little in the dark. I haven't been able to find much information and very few examples of plastic surgeries. So, this is one of the reasons why I decided to share my story here. I can't be the only one in this position - hemifacial microsomia is the second most common birth defect after Down syndrome. If you're in the same position as me, I'd love to hear from you.

Here my surgery plan:

* Yanhee hospital in Bangkok, Thailand.
Australian hospitals are way out of my price league - I currently receive a volunteers allowance and no salary, and will be saving up for surgery through photographic work... assuming I find enough of it here.

* I have made contact with the staff at Yanhee and I am waiting for feedback from surgeons, and final price estimates. So far, the prices I'm looking at are (based on their website and online consultations with staff):

*Rhinoplasty - $1500USD (I don't know yet if this includes Septoplasty)
*Mandibular Implants (Jaw) - $1700USD
*Neck Liposuction - $1300USD
*Allowance for extra procedures recommended - $1000USD
*Skin treatments for acne scarring & skin tag (associated with hemifacial microsomia) removal - $500USD

In addition, I've allowed $1000USD for flights and accommodation, giving me a total budget of $7000USD. It seems completely out of reach, but all I need to do right now is start. I am aiming for a surgery date in October 2014, which gives me 7 months to save... $1000 a month. That's a huge task. I better find those photography clients quickly!

I'll update this page when I hear back from the surgeons at Yanhee, hopefully with good news.

Thank you for letting me process my thoughts on here, and thank you for reading this far. I hope to show you the real "after" photos in 8 months time, and I'll be thrilled is they look even half as good as my lame Photoshop predictions!

Title... hmm.. Photos? :)

I may have used my photography skills for evil - I have Photoshopped these images to give my surgeon (and myself) an idea of how I could look after surgery. I have no idea how realistic I'm being and I know I could be giving myself false hope, but the way I see it, it's just hope.

And I cannot believe that I'm uploading terrible photos of myself to the internet for all to see, sans make-up (except for eyebrows!) and all. Forgive me, future self.

Quick update - hopsital changed & surgeon chosen!

Just a quick update - I've decided against Yanhee hospital. I still think it's a great hospital, but I feel that the jaw/chin correction is too complicated and I would like to go to a specialist. Bumrungrad hospital (also Thailand) had always been my preferred choice, however it was just too expensive for me. After further research and reading the profiles of their doctors, I found Dr Nond Rojvachiranonda. He specialises in craniofacial surgery and has been a bit of a pioneer in surgical techniques in Thailand. I have read extensively about his work and have a lot of confidence in his abilities. (and yes, I have seen the webpage set up by a patient of his claiming that he was negligent. I'm not naive but I think it's obvious to anyone that this patient is after money. One big tell-tale sign - they claim negligence but don't give photos of the so called "botched surgery" and don't describe it the issues. Plus, they do kind of come off as a bit of a raving lunatic! I've done a lot of research on this doctor and I'm not worried at all - at least no more worried than if I was having surgery with a top Australian surgeon!)

So, anyway! I found that Dr Nond operates at Bumrungrad (super exclusive and out of my price range) but he also operates at St Louis hospital. A "middle class" hospital that has the same surgical standards but just doesn't have the 5-star hotel service - I live in Cambodia so this is fine by me! ;) The rates at St Louis hospital are much lower, so this means I can have a highly specialised surgeon for Yanhee hospital prices. Good stuff! I'm going to Thailand in July to meet with Dr Nond for a face-to-face consultation so that he can properly assess me (rather than just looking at photos) and I will go from there.

I'm getting really excited, and working very hard to save money for this. After all these years - it feels like this is finally going to happen. I can be in a photo without cringing! Speaking of photos, I took some selfies last night and I like them so I'm sharing them to make up for the make-up-less photos I posted last time ;) x

More photoshop fun

Well, I don't have an update to post as I'm in the waiting & saving $$ part of this journey at the moment! To remind myself why I'm working so hard and living off bread and instant noodles I did some more playing around with Photoshop. So here comes another edited 'before & after'... again I'm so embarrassed to post the 'before', but I hope by Christmas I'll be posting the real 'after'! x
Dr. Nond Rojvachiranonda

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Hello. I read your posts with interest. Amazing how similar our stories are, right down to being photographers who have used our photo editing skills to "fix" ourselves. I too feel constantly ugly, and have had various people "helpfully" point out my flaws. I also had an unkind and dismissive review by a plastic surgeon in South Africa to whom I'd sent my most painfully honest photos - up close and personal. Well, at least it wasn't face to face. Anyway, I've learned a couple of new terms from you and a couple of your commenters for asymmetrical faces, and now I need to look them up to see if either explains my own face. By the way, you have big, beautiful eyes, and that means so much in terms of attractiveness to others. I have small eyes, and there is nothing that can be done surgically for that. So, you're lucky that way. You mentioned that you would be seeing a surgeon in July, and it's September now, so I'm hoping that your silence here is because you've been too busy to update, and not that you were disappointed by his assessment. I would love to hear how it went, and if he could offer anything useful to you. I DO think you're prettier than you think. And if it's any consolation, I used to date a guy with extreme asymmetry in his face, as well as spine. But he had big eyes, and full lips, and women were very attracted to him. And I, with my asymmetry, while no beauty, managed to get some really great, and even hot boyfriends, one of whom I married. So, despite the rude remarks of some people, and studies that show a majority of people find symmetry most attractive, that doesn't mean that everyone finds asymmetry to be ugly.
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Hi Sreysa'art, how was your meeting with Dr. Nond?
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Thank you for posting this post! I am almost 40 and if you think you were late in seeing your face differently I did not until I was 35! I always knew I had facial asymmetry but because it is not as pronounced in the mirror AND I had perfected the compensating photograph, I was convinced it was not as bad as it is! The fact is, in comparison, my face is WAY more asymmetrical than yours, I can honestly say that I wish my case was as subtle as yours. I am also concerned that the surgeon told you that their was little to be done, as I am going to see a doctor on Monday. So I am interested in how things work for you, I think you should know that you are quite attractive and I know from experience that may not make you feel better but I think it is important to tell you the truth from my perspective. Good luck with your surgery, please keep us posted, I am super curious about the experience, final cost and results. Take good care! Again thanks for sharing!
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Hi I'm 32 and also have hermifacial microsomnia that is quite noticeable I have had some mild corrective surgery with poor results. I don't think at the time myself or my parents were properly informed on the condition and the procedures out there. I'm still a little lost to tell u the truth can you help
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Hi there, I just wanted to comment and say I have the same condition- somewhat mild, but incredibly frustrating and all I see. Thank you for sharing your story and journey!
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Remember to look after yourself, bread and noodles don't sound very nutritious! You need to be healthy to have your surgery! Add some fruit, nuts and protein to your diet. You do sound motivated though, and you look gorgeous in before & after pics. Have you showed the after pics to your surgeon? They can be helpful to the surgeon so they know what you would like to achieve. Maybe even done with fewer procedures than you think. Thanks for the update! :-)
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Hello! I am an 18 year old male, with a very similar issue with my lower jaw. First off, I would like to make things clear... you are very pretty, and don't need a rhinoplasty! You have many attractive facial features (your eyes
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Sorry, my full message wasn't posted... continued.... (your eyes are !WOW!) The doctor agreed with your diagnosis of "hemifacial microsomia", but I am not entirely sure that is correct. Instead I believe you may have "condylar hyperplasia". I'm no doctor, and could very well be wrong, but I thought it may be something to consider. Were you a forceps delivery as a baby? I know that sometimes that can cause fractures in the jaw and cause asymmetric growth and development. I am currently also searching for surgeons in the United States. Please keep me updated! Good luck, and God Bless :]
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Hi Icon, thank you for writing and for your kind words! I'm not sure I agree about not needing rhinoplasty - I want that more than jaw surgery! I don't mind the size or even shape of my nose, I just want it to be straight, and it's very crooked now (technically I'll be having septoplasty). The diagnosis of hemifacial microsomia was only made by photos, not by a face to face consultation or x-ray so you're right - it's not confirmed. The doctor that I have found in Thailand is a specialist in craniofacial surgery and I have a lot of confidence in his ability to improve my condition. As said in my original post, I'm not looking for perfection, just improvement. The surgeon wants to meet with me face to face (obviously!) to make his full diagnosis so I'll be going to see him in Thailand in July (I live in Cambodia so it's not far to go!). He is confident that he can improve my nose significantly but he's unsure of how to operate on my jaw/chin until he sees me and can confirm exactly what abnormalities there are. The surgeon is Thai trained but has done fellowships in the US and Aus and is a leader in craniofacial surgery, so I'm very confident. I've done heaps of research!! Re. forceps, I was *kind of* - by that I mean that I was born by caesarian section with the aid of forceps (I was 6 weeks premature, which was a big deal in the 80's!). Thank you again, and good luck with your journey also.
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I agree. Hemifacial microsomia typically also includes an underdeveloped ear, neck, etc. I have a similar condition as this girl only it's the condylar hypoplasia condition. Seems like a round of braces and double jaw surgery is what is needed in my case.
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You, my dear, are a wonderful writer and much prettier than you think. That said, I totally get being so consumed by your perceived "ugly" looks and then feeling guilty for thinking about it so much. I hope you're able to grab this dream and make it a reality. Be sure to look for a board certified very, very experienced surgeon in rhinoplasty (and the other procedures). That surgeon's email sounded very cold and unkind. I'm sorry you were on the receiving end of that. Please keep us posted on your journey. I'll be checking this space.
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Hi Angiemcc, thank you for your kind words. I've uploaded more photos now - you may take them back ;) You're absolutely right about the importance of finding a good surgeon. It's a main concern of having my surgery outside of Australia and I'll be doing my research. I really don't want to end up being another "surgery abroad horror story"! You're right, the email from the Australian surgeon was very difficult to read, and then I thought about it and realised that he didn't have a responsibility to apologise to me seeing as he didn't create me this way. Perhaps he thought I already knew about my condition. I did not, though. I really hope I'll be updating you soon on progress with my consultation - still waiting to hear back from the surgeons at Yanhee. Have a terrible feeling that I might be told they can't operate. Thank you
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Hi, I'm from Perth too :-) I want to firstly commend you on the volunteer work you are doing in Cambodia! What a kind soul you have to do this. I agree with the other two posters, you are FAR from ugly! You are very attractive, and I think you have a really sweet and kind looking face. I wish you good luck on your journey, and I hope you can update us!
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Hi fellow Perthite :) Thank you for the kind words. Today I changed my profile name to "Sreysa'art" which means beautiful girl in Khmer (Cambodian). I wanted to remind myself that I still have beauty despite the things I want to fix. Thank you, and I will be updating as I progress :) x
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Hi hun, it's now September and I'm dying to know how you got on. Did you go and see the surge on and did you go through with the procedure?????
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