Andy M. Wexler of Falmouth, a plastic surgeon, will never forget meeting Chastity, a 13-year-old Kenyan girl whose severe burns had welded her arms to her body, immobilizing them.
“She had missed being seen by the visiting surgical team, but waited patiently for three months, by herself, begging in the courtyards and hallways of the hospital for her food and water,” Dr. Wexler said. “She waited, praying to be delivered from her own flesh.”
Dr. Wexler specializes in maxillofacial surgery, a term that covers reconstructive surgery of the face, oral cavity, head, neck, mouth and jaws. That includes cleft lip and cleft palate surgery. Through the course of 30 years of volunteer work in 19 countries around the globe, Dr. Wexler has met hundreds of patients who, like Chastity, are in desperate need of plastic surgery.
A graduate of Phillips Academy Andover and Dartmouth College, Dr. Wexler spent five years of general surgical training at the University of Massachusetts after receiving both his medical degree and master’s degree in physiology from Boston University.
“You will never be trained for all of the possibilities to be faced in plastic surgery,” he said. “In medical training, we are given a toolbox to use creatively to solve the non-textbook problems we encounter every day.”
In Western culture, plastic surgery is associated with making the body look younger—a nip here, a tuck there—as aging takes its toll. “Reconstructive plastic surgery is different. It is like giving the person a whole meal. Cosmetic surgery is like giving them an extra dessert,” Dr. Wexler said.
“Cancer surgery is, by its nature, deformative. You remove a breast, for instance,” he said. “Plastic surgery is transformative, and we are always optimistic about the outcome.”
For The First Time, A Child Smiles
Early in his career, after performing dozens of microsurgeries, Dr. Wexler discovered he simply did not like the work. He then trained in the Lefort surgical method and found his passion.
Lefort is the technique used in cleft palate repair. “In Lefort we cut the upper jaw, free it from the entire face, and pull it forward and down,” Dr. Wexler explained. The jaw must be pulled forward and down because a cleft palate freezes the jaw and flattens the face upwards and back, impairing movement and speech.
Most of his annual mission work—in three-week stints in the poorest countries on five continents—has been with children with congenital and traumatic facial deformities and burns. His most satisfying moments as a surgeon come after a cleft palate repair.
“I would stand, unseen, in the recovery room as the nurse handed the baby back to the mother, a changed child,” he said. “For the first time, she sees her child smile.”
Across The Globe, Love Unites
In a career that spanned 45 years, the last 17 as regional surgical director of Craniofacial Services for Southern California Kaiser Permanente, Dr. Wexler performed 7,000 surgeries and 50,000 patient clinic visits. More than 50 percent of his private practice was working with children.
His work in the United States was different from his mission work. In Zimbabwe, Vietnam, Cambodia or India he would find children who had sticks and stones for toys; their parents would sleep on the streets at night to be in line for the chance to have their child seen by a missionary physician.
When his team arrived for work just after dawn, they were greeted by hundreds of parents holding children. For many years, the visiting physicians performed delicate surgeries from 6 AM until midnight. Eventually the doctors lightened their surgical day, starting at 7 AM and ending at 8 PM.
Dr. Wexler said he discovered profound life lessons from working in struggling countries where clean water, dependable electricity, and food and water were scarce. Despite the physical deprivation, he felt a rich sense of community in villages where extended families and tribes lived together, supported each other and laughed together.
“It is a hard life they live, but a lot of joy and love is present in those communities. I came to understand that what binds us all together as humans is a parent’s love for their children,” he said. “When that relationship includes a pediatric plastic surgeon, we are integrated into the children’s and their parents’ lives. We are in a long-term relationship.”
Prior to his retirement from his California practice in 2017, Dr. Wexler came full circle in a physician-family relationship. He found himself surgically repairing the cleft lips of a baby whose mother had been a patient of his 25 years earlier. “That was a moment!” he said.
The Mission And World Are Changing
Historically, physicians from developed nations performing surgeries in developing nations would come in, do the work and leave. Today they focus more on building up that country’s capacity to heal its own patients.
“We go in to do the work, but now the emphasis is on training others to do the work and bring modern safety and culture of care, and technology, to make the system work in that country,” he said.
In October, he was called with a request to return to Kenya in December. “Of course, I’ll go,” he said. “I’m ready.”
Dr. Wexler will leave his wife, Geri, for three weeks once again as he has done for most of their 42 years together. Dr. Geri Wexler is a retired psychologist who shares her husband’s love for children and mission work. She has served as his medical record keeper on many mission trips. They have two daughters, Rebecca, 37, and Sarah, 35.
“The places I went to in the early years had no internet, no cellphones, and my wife would leave me at Los Angeles International airport with the words, ‘Do well, stay safe, and I’ll see you back here in three weeks,’” he said. Now he travels with a laptop and cellphone.
Dr. Wexler said that mission work is “free of all the trappings of modern medicine that suck the joy out of one’s love for the profession.” Without the profit-driven infrastructure of insurance billing codes, paperwork and bureaucratic imperatives, mission medicine is solely about the patient and the work.
“Volunteering one’s time and skill for those who need it most,” Dr. Wexler said, “is medicine in its purest form.”