By: Jessa McClure
As Oral and Maxillofacial Surgeon Dr. Dylan Bowles enters the clinic his team has set up in preparation for this day, he knows that he is about to help change the lives of children and their families.
Dr. Bowles has traveled thousands of miles since 2009, working to correct facial deformities and give children in Colombia, Mexico, and the Dominican Republic a second chance at life.
“What people don’t understand is that [Cleft Lip and Palate] is not just a cosmetic facial deformity, it’s also a functional deformity,” he said. “Children afflicted with facial cleft deformities are not fixed with more than just closure of the lip. They actually require up to seven surgeries to restore their ability to eat, speak, hear and smile.”
The doctor and his team repair their patients’ cleft lips around 10 weeks of age and their palates at around age one. Then the ears are evaluated for the ability to clear the ears (popping pressure) and if needed, ear tubes are placed to prevent permanent deafness.
The next part of the healing process includes a surgery around age six where a bone is taken from the hip and grafted to the upper jaw in order to allow teeth to erupt properly. The nose is also corrected around this time to allow proper breathing. In the child’s early teens he or she is fitted for braces and undergoes another surgery to improve the ability to chew.
“These children suffer from failure to thrive and are malnourished because they essentially have a lack of communication between their nose and mouth and throat that keeps them from creating a seal or suction with their lips. Due to this functional deficit the children have severe problems with nursing or breastfeeding, and typically suffer from speech impediments.”
To develop proper speech development, these treatments must be administers at an early age. But, unfortunately, Bowles has seen many older patients who have never received patients.
“Our patients range in age from three months to 50 years,” Bowles said.
Some of the older patients are seen as less intelligent because of their deformities, but there is no connection between cognitive ability and Cleft Lip and Palate. The cause is usually a result of poor nutrition during pregnancy, especially a lack of folic acid, he said.
And it isn’t just developing countries that have this problem.
“One in 650 live births in all of the Americas have [facial deformities],” he said. “But because surgical correction is much more efficient in the US, the average American doesn’t see the prevalence of these deformities.”
People with these deformities often suffer from depression and other behavioral and health problems.
“During our most recent trip to Ibague, Colombia, we evaluated several patients with syndromic features that not only affect the face, but also the heart and extremities,” Bowles said.
Because the problem is so prevalent in foreign countries and even the US, the doctor and his team are passionate about changing the lives of the patients they treat.
“Our motto is, we do it for the kids,” he said. “With properly-sequenced surgical procedures, form and function can be restored. Helping these little kids has been so rewarding, spiritually and emotionally. You feel so accomplished because you’re giving back to someone who would not otherwise have the opportunity to have this type of surgery.”
“My wife wears many hats,” he said. “She is typically one of the mission coordinators, patient organizers, preoperative nurses, or works as the First Assistant or in the post anesthesia care unit recovering the babies. It’s really important to have her there with me. We’re our own team.”
Bowles has had the privilege to work with several International Foundations that host Cleft Lip and Palate Missions. The Ibague Mission is made possible by the Drawing Alegria Foundation. Dr. Dario Garzon, who is the lead physician and co-founder of Drawing Alegria Foundation, has been performing facial deformity corrections for several years in Colombia. His foundation’s primary objective is to help children with cleft lip and palate deformities. He has created an extensive network of mission locations to be able to carry out their precious work.
What most do not understand is that the staff involved in mission work are never paid, the doctor said. The travel, instrumentation, supplies, lodging, and food expenses are usually left to that of the volunteer. Because the expense of treating patients in developing countries is so great, the Bowles have started an organization to not only make their travels possible, but to also to treat patients at no cost to them.
“My wife and I have developed Smiles of the Future Foundation,” Dr. Bowles said. “It’s an organization that will provide international and local surgical care for patients with cleft lip and palate deformities.”
They hope to someday partner with foundations such as Drawing Alegria and the Smiles International Foundation, to not only provide charitable services, but also to raise funds for other projects with help from our local communities.
Some of these local entities, who are providing funding for Bowles’ mission work and others, are local Rotary clubs. Bowles, a devoted Rotarian himself, works with clubs who are interested in helping kids with Cleft Lip and Palate deformities internationally and locally.
The help of Rotary clubs is not only important in the US, but in South America as well. In Ibague, Colombia, where Bowles and his team have treated patients, their local Rotary club not only provides mission workers with a hospital facility to do their work, but they also provide transportation, meals and lodging.
Bowles first developed a passion for facial deformity correction in children and others when he was still early in his training. Then, in 2003 when he joined the Army, he saw just how valuable corrective surgery could be.
“In the military, I had the privilege of caring for our soldiers wounded in battle,” he said. “I saw how several advances in [facial reconstructive surgery], especially facial transplantation, changed the lives of these military heroes.”
Bowles brings his military expertise and team-approach to his work outside of the military, training and working with Cleft Lip and Palate teams which may consist of pediatricians, surgeons, orthodontists, speech pathologists, and pediatric anesthesiologists.
“Usually the first day is our screening clinic where we could see up to 200 patients,” he said. “There are so many patients in need that we often work from daylight until dark to treat as many children as possible. We typically have several doctors in each specialty that work together in a team effort.”
The nurses and surgical technicians are instrumental in the efforts to provide a successful environment, Bowles said.
Although the doctor enjoys his mission work immensely, he is always happy to return home to Texas. He recently moved back to the local area to raise his family and enjoy life outside of the big city.
“I’m from this area and I always wanted to come back here and take care of the kind of people I most associate myself with.”
Bowles said part of his motivation for returning to the Erath County area is to provide his specialized services to those who might not have access to such care.
“There’s no one else in the area who provides the full-scope services or type of surgical care that I provide,” he said. “It’s something that’s typically found in a major metropolitan areas. So, I think it’s the best of both worlds. I don’t have to raise my family in the city, and the people of Erath County have access to care.
“The secret to life is to be able to give back,” he said. “It’s the greatest gift of all.”
Photos provided by Dr. Bowles