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Woman to Undergo Risky Facial Reconstruction Surgery Today in Louisville

For years, Lessya Kotelevskaya has not been able to open her jaw more than a few millimeters.In 2001, she was misdiagnosed with terminal cancer in her jawbone by a doctor in Kazakhstan, according to University of Louisville Physicians.The treatments left her face disfigured. Today, Kotelevskaya will undergo a complex, possibly day-long facial reconstruction surgery.“This is the big one,” said said Dr. Jarrod Little, a plastic surgeon who has been working with Kotelevskaya since her arrival in America. “This is when all the risk is."Kotelevskaya's cousin found her and her son, Erik, in 2013 in Kazakhstan. Kotelevskaya couldn't work because of the disfigurement—they were homeless, according to the practice. The cousin, Oleg Sennik, brought her to Louisville, where he lived. Since then, she's been receiving treatment with UofL Physicians, which offered services after learning of Kotelevskaya's story.Dr. Jarrod Little said the surgery involves connecting blood vessels so small that a microscope will be needed.“If you get a blood clot in one of those that means the whole thing doesn’t work,” he said.Little, 38, is performing the surgery, which is expected to take 16 to 24 hours, at no cost. He said it’s surgeries like Kotelevskaya’s today that are the “rewarding part of all of this.”“It’s why we do what we do,” he said.  “Plastic surgery is usually associated with cosmetic procedures, but this is the other aspect of cosmetic surgery, this is the reconstructive aspect, this is what we’ve trained so long to do.”He said the surgery will use bone, blood vessels and skin from Kotelevskaya’s fibula to reshape her jaw area.Her jawbone, which Little said is “no longer living” will be removed, along with the cheek and neck skin that has been damaged during past procedures.Following surgery, Kotelevskaya will be in intensive care for “at least” three to five days, as her highest risk of complications is within the first 72 hours, Little said.Doctors will consider the surgery successful if Kotelevskaya shows signs of improvement within five days, Little said.The surgery Kotelevskaya is receiving today is done at a much higher rate in Kentucky than the rest of the U.S., Little said.  That is due, in large part, to higher rates of alcohol and tobacco use.Officials with UofL Physicians will be live Tweeting updates from the surgery process, as well as posting videos and photos of the procedure. 

Jacob Ryan is the managing editor of the Kentucky Center for Investigative reporting. He's an award-winning investigative reporter who joined LPM in 2014. Email Jacob at jryan@lpm.org.