US and Canadian surgeons try to repair faces shattered by Ukraine war

Lesya Belinska is proud of her son. She stands next to Roman Belinsky at her home and hugs him with one arm. Belinsky waves her away, embarrassed.

Belinsky’s face is badly disfigured from a serious combat injury. The 42-year-old was discharged from duty recently, but still wears his army uniform.

“I am proud because you didn’t run and hide. You must be born with that. I am proud of my son and all his boys. If not for this, the Russians will destroy us,” his mother says.

Belinsky says he volunteered for a Ukrainian mechanized infantry brigade in 2020. Following Russia’s full-scale invasion in February 2022, it was one of the first groups to see combat.

Belinsky shows a selfie video from the first days of the war. With an impish grin, he reveals his unit speeding along on the back of an armored vehicle. He raises his fist.

“Slava Ukraini!” he shouts in the video, the now widely familiar cry meaning “Glory to Ukraine!”
In May, Belinsky and his brigade defended Huliaipole, in central Ukraine – the Russians threw everything at them, he said.

“We barely had time to dig in when they started bombing us. But we managed to dig in,” he said.

That night, Russian tanks attacked from both sides. His trench took two direct hits, he recalled.

“I don’t know how I survived. I don’t know how I survived the shelling. My eye was hanging out. I was concussed. My whole face was covered in blood. Shrapnel pierced my lungs through my body armor,” he said.

Field surgeons saved his life, he says. But what followed were months of painful and increasingly technical operations to try to put Belinsky’s skull and face back together.
A highly specialized team
Even in a country like Ukraine, with a sophisticated medical system and highly trained surgeons, it has taken a specialized US and Canadian team to deal with the extent of some of the injuries of Ukrainian soldiers and civilians. Typically, what we’re seeing here are blast injuries with multi-level injuries, soft tissue and bone and all of the surrounding organ structures. So, it really does not get any more complex than this, even in a combat scenario,” said Dr. Anthony Brissett, the Ukraine mission director of Face the Future – a medical foundation.Launched in 1996 by Canadian doctor Peter Adamson, Face the Future works across the globe – focusing on delicate reconstructive surgery. The foundation’s work included Russia until recently, but its efforts quickly pivoted to Ukraine after the full-scale war began.

Adamson says he handpicked the surgeons for the specific injuries they would encounter. They planned remotely for months with a Ukrainian surgical team.

The surgeries were planned for the relative safety of Ivano-Frankivsk, a small city in western Ukraine. The doctors scheduled multiple surgeries over the week, holding video calls and exchanging x-rays and CT scans long before they arrived. This is also not their first mission to Ukraine.

Challenging cases
“We need people with a humanitarian spirit and the right attitude. There’s no place for people who are prima donnas, or people who have things perfect and just right all the time,” Adamson said.

On the first day of consultations at the Ivano-Frankivsk regional hospital on Monday, the surgeons took turns assessing some 35 patients.
Twenty-seven-year-old Dima nervously stepped in. Like most active-duty soldiers in Ukraine, he preferred not to share his last name.

Dima told how his convoy hit a landmine – the blast tore through the left side of his face. Where Dima’s eye should be, Ukrainian surgeons sewed over a flap of skin.

“Will you be able to make eyelids?” Dima asked tentatively, through an interpreter.

Dr. Raymond Cho, said by his colleagues to be one of the very best ocular plastic surgeons around, paused before answering.

“I can make an opening that looks like an eye, and put in a glass eye, but they are never going to look like normal eyelids,” he replied.

“OK,” said Dima, clearly crushed.

“It is very difficult. These are some of the most challenging cases that I have had to deal with in my career. Personally, I just must tell myself that all that I can do is the best that I can do and hope the patient understands,” Dr. Cho, who spent more than 20 years as a US Army physician, including a tour in Iraq.

A years-long commitment
Some of the surgeries the Face the Future team carries out in Ukraine will have an immediate impact.

But there are other cases, like Belinsky’s, that could require multiple surgeries and recoveries. So, Dr. Brissett says he expects a five- to 10-year commitment from the surgeons involved.
Belinsky stepped in for his consultation and gave Dr. John Frodel a confident handshake.

This was to be his third procedure with the surgeon, usually based in Ithaca, New York, who has come back again to Ukraine.

“We will try to lift the eye up to make it more symmetric with the other eye. Is that what you want?” Frodel asked.

Belinsky shrugged. Some back and forth followed through the interpreter, as future surgery options were discussed. Belinsky said he wanted to fix his cheek implant, but that he needed more time before doing more work than that.

“You have to appreciate that the day they were injured is probably the worst day of their life and they need to understand that they are going in a positive direction. Our hope is that at some point they leave happy and then I don’t see them again,” said Frodel.

Belinsky got up, pulled his red and black military patch off his shoulder to give to Frodel, and gave him a bear hug.

Physical and psychological healing
For Belinsky and others like him, the surgeries are about much more than simply the physical trauma of their injuries.

“A person’s appearance reflects their inner spirit. We must never forget this is not vanity. It is part of the human condition,” said Adamson, the founder of Face the Future. “These individuals have suffered devastating injuries and we have to help them deal psychologically with what we can change and what we cannot.”

The next morning, Belinsky walked into the operating theater in shorts and a t-shirt and placed plastic covers over his shoes.

Technicians readied a live broadcast that will help train Ukrainian surgeons.

The anesthesiologist put a mask over Belinsky’s face and he drifted to sleep. Frodel made his first incision.Speaking before the surgery began, Belinsky told how he often cannot sleep until just before dawn, reliving battles in his head. He wants to go back to the frontline but knows that he will just be a burden, he said.

Belinsky added that many of his original brigade have been killed or injured. The Ukrainian military does not disclose casualties.

But he doesn’t feel lucky.

“We are all like one family. You know, somewhere you feel your guilt, guilt that you did not die like they did,” he said.