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Erasing the scars of abuse

Melissa had been beaten for so long that her face

literally collapsed.

Her nose, after 17 years of punches by her abuser, had flattened flush

against her face, making it difficult to breathe. The repeated blows caused her

tendons to loosen from her lower eyelids, which then drooped - a condition

more common to people in their 70s than to a woman who is 42.

Now, through the help of a Great Neck plastic surgeon, the face that stares

back from Melissa's mirror shows few signs of her ugly past.

In the six-hour operation at Long Island Jewish Medical Center in New Hyde

Park in October, Dr. Andrew Jacono harvested a rectangular piece of bone from

her skull, reshaped it, and used it to rebuild the bridge of Melissa's nose. He

used cartilage from her right ear to shape the nose's tip. Finally, he made

incisions under her eyes to lift the sagging lids. The surgery could have cost

up to $40,000, Jacono said. But for Melissa, it was free.

Melissa, a mother of two, agreed to be photographed but asked that her last

name not be used for fear of retribution by her former partner. A Nassau

County resident, she said getting surgery was never something she considered

because of its high cost. "There was always something more important that my

kids needed," she said at a news conference yesterday at the Long Island Jewish

Medical Center, where she unveiled her new face. Now, she said, "I can look in

the mirror without that constant reminder."

Melissa said she suffered for years at the hands of her partner, who often

aimed his blows at her face. "When I'm done with you, no one else will ever

want you," she remembers him threatening.

Sandy Oliva, executive director of the Nassau County Coalition Against

Domestic Violence, said such threats are common. "It takes tremendous courage

for victims to reach out," she said.

After two particularly brutal beatings in August, Melissa called the

group's hotline and asked for help. She got an order of protection and the

coalition helped her pay for a new apartment. She's looking for a job and

thinking about going to school. Today, in fact, she is taking an exam to get

her high school equivalency diploma.

Jacono has been donating his services to domestic violence victims for

about seven years, ever since he performed facial surgery on a woman who

initially told him she had been in an auto accident. He discovered she was a

victim of domestic abuse when the patient returned a few months later. "My work

had been completely destroyed," he said.

Since then, Jacono has been involved with Face to Face, an Alexandria,

Va.-based nonprofit that provides free surgery to domestic violence survivors.

He also serves on the board of directors for the Nassau County coalition.

Although there is pride in Melissa's new face - including the nose that

turns up just so - Jacono knows the real accomplishment is hers alone.

"She's made huge strides in her life," he said. "This is just the icing on

the cake."

Delicate procedure

How Dr. Andrew Jacono and 12 staffers of the Long Island Jewish Medical Center

repaired the patient's facial damage after six hours of surgery.

Harvesting the tissue

Rebuilding her face

A new look (2 months later)

Only thin piece of bone is removed. Skull regrows tissue.

Cartilage removed from ear and Cartilage grafted to nose

Damaged tendon

Damaged cartilage

Damaged bone

NOSE

The damage: Bone and cartilage were destroyed, causing deformity and

restricting breathing.

How it was repaired: Fragments from the damaged tissue were removed. Doctors

then took a strip bon bone from the skull and cartilage from the right ear and

grafted them in the nose to restore its shape and ease breathing.

EYES

The damage: in a normal eye, tendons help hold up the eyelids. In the patient,

years of abuse loosened the tendons, causing the lower eyelids to sag.

How they were repaired: Doctors made incisions in the eyelids and retighten the

tendons.

Researched by Katie Thomas and Andrew Wong, Graphic /Rod Eyer

Abuse hotlines

Nassau County

Coalition Against

Domestic Violence:

516-542-0404

Suffolk County

Coalition Against

Domestic Violence:

631-666-8833

Victims Information Bureau of Suffolk: 631-360-3606

The Retreat: 631-329-2200

Brighter Tomorrows: 631-395-1800

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