From October 2 to 8, the fourth mission of facial reconstructive surgeons from the United States successfully took place in one of the hospitals of Lviv, in collaboration with Razom for Ukraine, INgenius and many other partners.

Preparations for the mission began in the spring of 2024 and lasted over four months. During the patient selection process, nearly 100 applications were reviewed, and 35 of the most complex cases were chosen for reconstructive surgeries. Some of these patients were scheduled for surgery in May.

A total of 19 soldiers with serious defects of the ocular and frontal areas, midface area, significant damages of the soft tissues, nasal bones and oral cavity were successfully operated.

Some of the patients received implants to replace bone defects, including expensive highly technological patient-specific titanium 3D implants. All surgeries and consultations for the mission participants were provided free of charge.

Ukrainian surgeons, anesthesiologists, and nurses worked for seven days together with the American medical team.

The following procedures were performed with common efforts:

• Nasal reconstruction with a free forehead flap on a vascular pedicle – 7
• Placement of the PSI (patient-specific titanium 3D implant) – 3
• Commisuroplasty – 3
• Placement of spherical orbital implants made of porous polyethylene (Medpor) – 5
• Orbital floor/rim repair with titanium/porous polyethylene implants – 3
• Eyelid reconstructions – 10
• Upper lid gold weight placement for the correction of paralytic lagophthalm – 2
• Midface lift – 3

Additionally, there were scar revisions, canthoplasties, upper and lower eyelid fornix reconstructions, eviscerations, placements of ocular prostheses, lip reconstruction, cranioplasty, fat grafting for cheek tissues, and other operations.

It is also important to emphasize the significance of the training provided to Ukrainian specialists during the mission. The goal of the American colleagues was not only to help severely wounded soldiers but also to pass on their experience to Ukrainian doctors. Therefore, even after the mission, the skills acquired can be applied to treat other complex patients.

Moreover, all operated patients will continue to be monitored by Ukrainian doctors, who will report on their condition to the American colleagues, which will allow the optimization of the recovery processes.

Some patients will undergo further stages of surgery and, if necessary, will have the opportunity to seek help from American doctors during the future missions.

The first week of October was highly productive for the mission team and successful for our patients.

Therefore, the INgenius team expresses its sincere gratitude to everyone who made this project possible.

We are grateful to:

The team of American surgeons and nurses:

Parag Gandhi — MD, Ophthalmology & Oculofacial Plastic Surgery, Baltimore.

Ryan Daniel Winters — MD, Facial plastic and reconstructive surgeon, Australia, Newcastle.

John Frodel — MD, Facial Plastic Surgery, Otolaryngology, Guthrie.

Augustine Moscatello — MD, Professor, Chairman at the Department of Otorhinolaryngology—Head and Neck Surgery, New York Medical College.

Ivanka Nebor — MD, resident in Otolaryngology-Head and Neck surgery, Westchester Medical Center.

Yurij Tsuvanyk — Nurse

Jamie (Harold) Orange — Surgical tech

For their invaluable contribution to the health of our servicemen and to the training of Ukrainian doctors.

The team of Ukrainian doctors:

Plastic surgeon Vitaliy Panchenko for his assistance in the implementation of the mission, organizing patient acceptance at his department, and performing surgeries at his hospital.

Also, a special thanks to the highly qualified and organized team of surgeons, anesthesiologists, interns, nurses, and junior medical staff at the Ukrainian hospital who were always ready and worked clearly, professionally, and in harmony.

The members of the INgenius team: • Ivanka Nebor, Kyrylo Chuhai, Yelyzaveta Baran, Anna Tovkes, Ihor Solovey, Daryna Chernenko for organizing the patient selection and the high-level performance of the mission.

Materialise Company for the production of 3D implants for our defenders, and also to the volunteers from the company — Anastasia Krychun, Olga Hornyak, and Kateryna Stepura for their assistance in preparing models and their high-quality visualization during the surgeries.

Razom for Ukraine Organisation for their huge work ensuring the comfortable stay of our American colleagues in Ukraine, providing financial support, supplying consumables for the surgeries, and offering comprehensive support. Special thanks to Lileya Dzhaliuk, Yuliia Shama, Nataliya Kuts, Nataliya Sawka.

Our partner organizations: FIGS, Cherokee Ukraine (Medgroup), Vasyl Shevchik's Ocular Microsurgery Center

And finally, we thank Vasyl Salyha for the excellent photo report!

See you at the future Missions!