Surgeon's gift: a happy face for little Sean

By CATHERINE MASTERS

Sean Martinovich is a boy who cannot smile. But Kidz First plastic surgeon Glenn Bartlett hopes seven hours of surgery has changed that.

Last year, 6-year-old Sean, from Whitianga, had life-saving surgery when a golf-sized tumour was removed from his brain stem.

But the operation left half his face paralysed. He talked with a slur, sometimes dribbled out of the side of his mouth and could not close his eye properly.

Although he could run around with the other boys in the playground, when they laughed he could not laugh with them.

Without a smile, he could suffer psychologically and emotionally, Mr Bartlett said.

Last week, Sean had seven hours of microsurgery that should give him back his smile.

Mr Bartlett removed a nerve from the back of one of Sean's legs and transplanted it into his face.

On the normal side of his face the nerve divides into lots of little branches.

Mr Bartlett, speaking before the operation, said some of those could be sacrificed without affecting the function on Sean's good side.

"We will expose the facial nerve on the good side of his face and we'll identify which of the little nerve branches can safely be sacrificed.

"We'll cut those nerve branches and then we'll take a nerve graft from one leg and tunnel it across his face from one side to the other and join that on to the nerve that's been cut on the good side of his face."

Sean is not smiling yet. Over the next six months the nerves will grow across the face to the damaged side and after that movement will hopefully come back.

Sean's facial palsy was an expected consequence of his brain surgery but fortunately he lost function in only one side of his face.

But if this was not fixed he could face physical and emotional problems as he got older, Mr Bartlett said.

"Socially people can become quite withdrawn because of the face symmetry. It's not uncommon for people, especially children, to become rather emotionless because they prefer the flatness of no movement on either side to the weirdness of an asymmetry of smiling on one side and having this twisted face."

Sean's parents, Steve and Wendy Martinovich, said they had been through a year of hell.

Their son's brain tumour was sudden and his surgery major, but he was a determined boy who just got on with it, said Mrs Martinovich.

Over time he has slowly been able to walk and talk again.

They are amazed at the technology that they hope will restore the cheeky smile they love so much.

For Mr Bartlett the microsurgery is almost routine. For Sean's parents, it is a miracle.