A nonprofit in New York has an admirable mission: to provide free plastic surgery for low-income children who have facial deformities. Some of the kids who apply to the Little Baby Face Foundation do so because they are being teased over their looks. But is plastic surgery a smart way to help bullying victims?

For 15-year-old Renata and her mother, the answer was yes. Renata had been taunted so cruelly over her appearance that she stopped attending school altogether; she’s been home-schooled for the last three years.

“They were just calling me ‘that girl with the big nose,’” Renata told NBC News. “It just really hurts. And you can’t get over it.”

Watch the Dateline NBC report Sunday, Jan. 5, at 7 p.m. ET

Last year, Renata and her mom Michelle, who asked that their last name not be used, read about another girl around Renata’s age, named Nadia Ilse. Bullied over her looks, Nadia transformed her appearance through free plastic surgery provided by the Little Baby Face Foundation. After that story hit the media, the Little Baby Face Foundation received hundreds more calls and applications than usual. Renata's mom was one of them — she called the foundation and she and her daughter worked on the application. “I tried convincing myself that I am fine the way I am, but I just don’t believe it anymore,” Renata wrote in her application letter.



The idea of using plastic surgery to stop a child from being bullied has some experts very concerned, including New York psychologist Vivian Diller, who has written extensively about the issue.

“Are we saying that the responsibility falls on the kid who’s bullied, to alter themselves surgically?” Diller asked in an interview with NBC News. “We really have to address the idea that there should be zero tolerance of bullying, and maybe we even have to encourage the acceptance of differences.”

Before her plastic surgery, 15-year-old Renata was diagnosed with a condition which caused her nose to lean to the left. Today

Renata’s mom disagrees. To her it's similar to correcting any other sort of medical problem a child might have. “Parents correct kids’ teeth with braces to make their teeth straighter,” the teen's mother said. “They’re still the same kid on the inside, but, unfortunately, people are judged on how they look.”

The Little Baby Face Foundation got a huge amount of media attention over the Nadia Ilse story, but doctors at the nonprofit insist they are not running an anti-bullying organization. Dr. Thomas Romo, the director of facial, plastic and reconstructive surgery at Lenox Hill Hospital and the Manhattan Eye, Ear and Throat Hospital, runs the foundation, which was started in 2002. Romo has treated children with deformities all around the world and wanted to bring that idea home to the U.S.

The organization’s intent hasn’t changed since its inception: correcting low-income children’s facial deformities, such as a cleft lip, or facial palsy, says Romo. If a child seeks the gratis surgery simply because he’s being teased over his features, he won’t be chosen unless the problem meets the medical definition of a facial deformity.

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That’s what happened to Donovan Killgallon, a 16-year-old from Wisconsin who applied to the Little Baby Face Foundation after being tormented over his small chin.

“There were times where people would walk around with their heads cocked back or something, to make it look like they don’t have a chin, to mock me,” he told NBC News. “High school’s hell.”

Donovan ultimately wasn't chosen by the foundation, because his complaints with his looks were judged to be “cosmetic.”

The point, Romo says, is to transform deformities — something that often does result in a transformed life.

“You take a child, and you change the way they look. To anybody who sees them, they’re good-looking,” Romo told NBC News’ Hoda Kotb, in a segment to air on “Dateline” on Sunday. “That gives the child strength. We can’t go after the bully. But we can try and empower the children.”

Renata was chosen to receive the plastic surgery after Romo diagnosed her with a hemi-facial microsomia, which left her face underdeveloped and caused her nose to lean to the left. It’s the second most common facial birth defect after clefts, occurring in as many as 1 in 5,000 newborns, although that may be an underestimate, because the condition is often not diagnosed, or treated.

Like Renata, many children with hemi-facial microsomia may not even recognize that they have a deformity. All Renata knew was that she hated her crooked nose, and that Romo was offering her a new one. But he offered her something else, too: a new chin, to provide balance to her face, he said. The teenager had never considered her chin to be a problem before, but she and her mother agreed to the implant.

Romo believes that once the deformity is gone, the bullying will likely stop, too.

That’s not necessarily how it will work, experts say. Parents of these children need to make sure their kids understand that though this surgery may “fix” their facial deformity, it will not magically fix all their problems, says Gail Saltz, a New York City psychiatrist.

“They may do the surgery and expect happiness to result, or, let’s say, ‘I’m not going to be bullied anymore,” Saltz says. “But it may not turn out that way, because bullying is complicated, and usually it isn’t down to one physical attribute.”

Research is starting to show that kids with physical deformities aren’t necessarily picked on because of their looks; there are many other factors going on, says Chad Rose, an assistant professor at the University of Missouri. His work focuses on children with disabilities, not facial deformities, but he says much of it is applicable to the children applying to the Little Baby Face Foundation.

“Outside of appearing different in a noticeable way, two of the biggest factors are social skills and communications skills,” Rose says. “Students with low social skills and low communication skills tend to be victims.”

Changing a child’s appearance is an “extreme” decision, but if families decide it’s right, equal attention must be given to that child’s social and emotional well-being in order to effectively address the problem of bullying.

“We are never going to forget the experiences that we carry with us,” Rose says. “We will never forget the victimizing experience. The one message I wouldn’t want out there is that if you are being teased for some type of problem with your physical appearance, that if you simply change your physical appearance that all the bullying will go away.”

In fact, Donovan, the young man who was denied free surgery by the foundation, told Dateline he ended up solving his bullying problem without surgery.

Rose and other experts say it’s important the teens be given a mental health evaluation and counseling, before and after their surgery.

The Little Baby Face Foundation does not offer the children mental health services, but Renata did receive counseling before making her decision to proceed. And although her counselor was initially against the idea of surgery, she eventually thought the procedure would help the teenager to feel better about herself.

A few months after the surgery, Renata’s mother said her daughter was happier than she’d seen her in years. The 15-year-old even plans to return to regular school.

“I feel happy and I feel confident, and I feel like I don’t have to hide myself anymore," she said.