Thursday, December 17, 2009

For the Holidays—Plastic Surgery?

’Tis that season again—when our mailboxes fill with insistent recommendations for wish-listing, gift-giving … and tax-deductible philanthropy.

In some happy instances, the spirit of giving elides easily with year-end financial planning—as for example in name-dedicated donations to charitable projects of choice. I like
Smile Train very much, along with other medical organizations that offer free surgery to repair disfiguring anomalies in children of the developing world. Children’s Surgery International is a Minnesota based, non-profit volunteer organization that specializes in cleft lip and cleft palate reconstructive surgery for children who have no other access to medical care. And both of these are the progeny of Operation Smile. Some distance has opened among those charities, not to say that they are rivals, for the services they deliver are priceless by any measure. Still, their differences differentiate them:

Celebrity studded Operation Smile, founded in 1982, delivers treatment and training through traditional international medical missions, spending hard-raised millions to fly doctors and equipment to some 51 countries around the world, boasting 4,000 active medical volunteers—and more than 135,000 young lives resurrected. That’s good. Its website offers a wealth of resources, within and outside of the organization.

Smile Train, described by The New York Times as “one of the most productive charities, dollar for deed, in the world…”, makes the improbable claim that 100% of donor dollars go to recipients. This is at heart a matter of accounting practice. Operating on a business-for-profit model, eschewing the mission model of Operation Smile, Smile Train educates and equips local doctors to perform cleft surgery year-round in situ. Founder and one-time advertising exec Brian Mullaney asserts a cost-per-surgery savings of 90+%. That would be even better.

But the measure of this work must be taken more broadly. Cleft children in many countries are shunned, shamed, barred from going to school, getting jobs or marrying. In many places they are lucky to live—midwives in Chennai, India, are sometimes paid off to smother baby girls born with cleft deformities; an infant girl in China abandoned in a garbage dump was rescued by a man who sacrificed his marriage to make sure the baby's cleft lip was repaired; a young man who borrowed money traveled for two days across Nicaragua in hopes that, when his cleft lip was repaired, he would receive a kiss from his father....

In the United States and other developed nations, clefts are no less common an incidence than they are elsewhere in the world (approximately 1 per 500-700 births), but we very rarely see them here, because they are routinely repaired
shortly after birth, which is the optimal time. Fixing a child’s cleft lip or palate is a relatively cheap procedure—Smile Train figures its cost per child at $250. But families that subsist on less than $1 a day have little hope of saving that much in a lifetime—a sum which pales beside the cost of even the most minimally invasive cosmetic treatment in the developed world.

And then, there was this...

There in my inbox, cheek by jowl with poignant images of desperate children, one hearty invitation to give the gift of a better smile to someone who already has a pretty good one: “What better way to ring in the New Year,” says Dr. Patrick McMenamin, MD, President of The American Academy of Cosmetic Surgery, than to gift that cosmetic surgical procedure to a loved one who’s been craving it. Dr. Mark Berman of AACS suggests: “Make sure you’ve discussed the idea in the past so it doesn’t come as a surprise.” And, says Dr. Peter B. Fodor, MD, of the American Society for Aesthetic Plastic Surgery, “…It's important to remember that cosmetic surgery is not a commodity like a handbag or tie, where one size fits all."

Well. I guess the recession makes everyone market harder. Let each of us decide how best to give a holiday gift that keeps on giving...perhaps a world away, into the future, AND closer to home (tax time is coming).