Warning: This story contains graphic details of a transformational surgery.
But it contains beauty, too—the true story of a little girl, who after years of living with a malformed face, is stepping into the opening lines of a fairy tale—with the help of her pediatric plastic surgeon prince, John Polley, MD.
Born with Crouzon syndrome, a condition which stunts facial bone growth, Jessica Jaskowiak suffered from bulging eyes, impaired hearing and speech, as well as breathing and chewing difficulties.
A lot of that changed recently when the 11-year-old Illinois resident underwent a six-hour surgery at Spectrum Health Helen DeVos Children’s Hospital.
Dr. Polley’s goal? To move Jessica’s face and forehead forward with the installation of a rigid external distraction device, more commonly known as a RED device.
For the family, it’s been 11 years of waiting for this day and wondering how the surgery will transform their daughter’s life.
Jessica’s parents, Lynn and Paul, welcomed Spectrum Health Beat to chronicle Jessica’s amazing transformation from pre-op to post-surgery.
“We don’t mind sharing this story because there are so many people out there who have similar experiences,” Lynn said. “All kinds of families are going through things and you want to help somehow. You’re helping build a little more awareness and making the people around you more understanding of children who have certain types of situations.”
On a warm Monday in August, Jessica, Lynn and Paul arrive at the Helen DeVos Children’s Hospital Plastic Surgery office at 426 Michigan St. for a 2 p.m. appointment with Dr. Polley.
Despite anxiety about the next day’s surgery, Jessica bounds into the office and darts to the receptionist’s desk.
She arrives with a box of books, puzzles and games she wants to gift to Dr. Polley’s waiting room through her mom’s nonprofit organization, Project Angel Eyes.
“She’s just so caring and compassionate and worries so much about other kids,” Lynn says. “She just has that sense of caretaking. I think because she’s had so many people taking care of her—teachers, therapists, people that have been in her life. She’s constantly wanting to help.”
Lynn and Paul knew for a while that this time in Jessica’s life would arrive.
“We’ve known since the day she was born that this was pretty much the course,” Lynn recalls. “We connected with Dr. Polley when Jess was 2 or 3. We knew we needed somebody who lived and breathed this surgery, someone who didn’t just do a couple of these a year.”
Dr. Polley is a pioneer in the field of pediatric plastic surgery, having developed both the technique and distraction device to accomplish this life-changing surgery.
The theory is, Dr. Polley breaks or cuts bone in the affected area, which signals the body to grow more bone. He attaches metal plates and a halo device, which slowly stretch the area, ultimately making the body create more bone.
“For Jessica, we’re going to advance her entire face and her forehead,” Dr. Polley says. “Everything from the top of the head to the lower jaw is going to come forward. Jessica is going to have the biggest procedure we do in pediatric plastic surgery in terms of magnitude and extent of surgery. If things go well, the rewards will be great. We’ll be able to really transform her.”
Dr. Polley and Jessica hug after the pre-op appointment, in which he explains the next day’s proceedings to Lynn and Paul. They pose for photos.
“She’s Hollywood all the way,” Dr. Polley says, laughing.
Jessica begs him to look at the box of goodies she brought.
Against Lynn and Paul’s efforts to let him escape because of a “busy schedule,” Dr. Polley goes behind the receptionist’s desk, lifts books and puzzles from the box, and praises Jessica for her thoughtfulness.
She leaves the office beaming, in search of the best grilled cheese sandwich in town before fasting begins at midnight. Later, Jessica falls asleep with her family in the Renucci Hospitality House.
Lynn doesn’t sleep well. Her mind spins with anticipation of the next day. For many parents of children undergoing complicated procedures, these surgeries are emotionally more difficult for them than they are for their children.
Dawn arrives at Helen DeVos Children’s Hospital. With it, Jessica, her stuffed lamb, Lynn and Paul arrive at the Level A surgery registration area.
Jessica is directed to Room 3. She slips into a Garfield hospital gown. A nurse presents sock choices. She picks her favorite color—yellow. Next, the nurse gives her a choice of stuffed animals. “Spunky” the dog becomes a companion to Lambie.
“Your big job today is to relax,” Paul tells his daughter as he cradles her in his arms.
The nurse confirms the procedure with the family. Dr. Polley and the anesthesiologist visit the room.
Jessica grows woozy after the anesthesiologist administers an initial sedative.
Lynn kisses her daughter on the forehead, then slips into a jumpsuit and mask so she will be ready to walk with her daughter into the operating room.
“You look like a doctor girl now,” Jessica comments, eyes half-closed.
Disney’s “Frozen” blares from the in-room television. The lyrics seem to match the mood: “For the first time in forever, why am I so ready for this change?”
In the operating room
Lynn walks alongside Jessica’s bed as she is wheeled into the operating room. She sits on a stool holding Jessica’s hand as the anesthesiologist sedates her daughter.
“I’ll just be glad when it’s over,” Lynn says.
She kisses Jessica’s face, realizing that this face is about to experience the beginning of a long-awaited transformation.
“Take good care of my girl,” she says to Dr. Polley and the surgical team as she leaves the room with a prayer in her heart.
Lambie and Spunky are the last to leave. Lambie has been with Jessica through every surgery. This time Lambie waits outside in the hallway on a gurney.
Dr. Polley, wearing oversized retro glasses, takes charge of the surgical team, which includes fellow Spectrum Health Medical Group pediatric plastic surgeon John Girotto, MD.
Prep, including separating and braiding Jessica’s hair, an extensive cleaning of every inch of the child’s skull, marking, and sewing her eyelids shut, takes almost 90 minutes.
Dr. Girotto checks a 3-D model on the computer screen and reviews where critical cuts will be made.
He explains what will happen next.
Dr. Polley makes an incision through the skin on top of Jessica’s head. He places surgical sponges around the incision to absorb the blood.
In a tedious procedure, he cuts under the incision and beneath the skin on Jessica’s forehead. Dr. Polley and Dr. Girotto put clips in place, then peel the skin down and away from the skull.
Dr. Girotto explains what will happen next. Lawrence Foody, MD, a Spectrum Health neurosurgeon, will cut through the bone of Jessica’s skull, being careful to avoid the brain.
There are no lunch breaks for this team of pediatric surgeons. No bathroom breaks, either. They move on with a purpose that involves an intricate series of measured steps in the master plan for this surgery.
Dr. Polley inserts a metal plate over the cut in Jessica’s skull. This is where the main bone growth will happen. He tightens screws into the skull bone to hold the plate in place.
Next, he inserts a screw into each eyebrow. This is where wires will attach to the metal halo, which Dr. Polley will install after about a week of healing.
Robert Mann, MD, another Spectrum Health Medical Group pediatric plastic surgeon, stops by to check on the progress.
Dr. Mann explains that prior to Dr. Polley’s technique, this type of operation was dangerous because of the potential risk of infection.
With Dr. Polley’s procedure, the tissues move slowly so they have time to adjust.
Over the course of several weeks, after the halo is installed, Lynn and Paul will turn screws that will slowly adjust the halo to promote bone growth of about 1 millimeter per day.
“This was only made possible by Dr. Polley’s ingenuity,” Dr. Mann said. “He’s the one to come to when you have that exceptional child.”
It’s more than five hours since Jessica was wheeled into the operating room.
Dr. Polley finally takes a break and sits down.
“I’m already reviewing the surgery in my mind,” he says. “This is a very detailed operation. The staff did a great job. We don’t celebrate until we get the job done, but this went great. Jessica did really well.”
“Great job, you guys,” Dr. Polley tells the team shortly after 2 p.m. as the surgical staff washes Jessica’s hair and cleans her face.
He leaves the operating room, takes off his gown and mask, and prepares to meet with Lynn and Paul.
The parents look tired as they sit in the conference room. Tired, but relieved and cautiously excited on one of the longest days of their lives.
Dr. Polley enters the room and sits down. His smaller street glasses have replaced his surgical ones.
“She’s doing great,” he tells the couple, who let out a collective sigh. “It couldn’t have gone any better. I’m not breaking open the champagne bottle yet, but this was a big hurdle we needed to do and we got it.”
He explains the next steps. After the halo is installed, Lynn and Paul will need to turn the screws twice a day to stretch the skull and promote bone growth.
Both a little anxious, but well aware of the road ahead, they know they are in this together.
“A month from today you’ll be done turning,” Dr. Polley tells them.
Paul pauses for a moment, his mind pondering the past, as well as the future.
“It will go fast,” he says. “This 11 years went fast.”
They thank the good doctor. They return to the surgical waiting room while Jessica is in recovery.
Their hopes, and their prayers, have landed, their fairy-tale ending begins to take flight.