Graduating from high school and being accepted into the university of your choice are noteworthy accomplishments for any teenager. For 18-year-old Amy Buell, those achievements are all the more significant because of the challenges she faced along the way.

Buell was born with a cleft lip and cleft palate, birth defects that occur when the right and left sides of the lip and the roof of the mouth fail to grow together as the baby develops inside the womb. Besides being unsightly, these defects can cause significant problems with a child’s feeding, teeth, speech and psychological development. But thanks to the efforts of St. Luke’s Chief of Plastic Surgery George Wu, M.D. and a team of other skilled medical professionals, Buell’s future is bright.

“I was privileged to get the help of Dr. Wu and other specialists who had the knowledge and expertise to correct my cleft lip and palate and the problems associated with those defects,” says Buell. “They helped me become the person that I am today.”

Finding the Right Help

Shortly after her birth, Buell’s family tried to have reconstructive surgery performed at a hospital near Pacific Grove, where they live. Because of the difficulties associated with administering anesthesia to an infant with cleft lip and palate, the anesthesiologist was unable to put her to sleep for the surgery. That’s when Buell’s mother contacted Wu.

“I was working with the late Dr. David Haskin, a pediatrician at St. Luke’s,” Wu recalls. “We had coordinated a clinic funded at what is now the Pacific campus of California Pacific Medical Center, and the Buells heard about it. We performed the first surgery on Amy’s cleft lip when she was about 4 months old, followed by surgery on the cleft palate six months later.

“Several years later, when she still had some difficulty with her speech, we did a secondary procedure at St. Luke’s to tighten the space at the back of the mouth to reduce air loss through the nose,” he adds. “We performed a final procedure two years later at St. Luke’s before her permanent teeth erupted. We took bone from her left hip to insert between the gums, the palate and the base of the nose to bridge the gap in the bones at the roof of the mouth.”









Amy Buell before reconstructive surgery helped to restore her facial features.

Wu has performed many cleft lip and palate surgeries over the years. “Most of these surgeries are performed at university hospitals,” he says, “but many patients prefer the personal touch that we provide in a private practice setting as opposed to the ‘institutional’ treatment provided at larger hospitals.”

Wu notes that correcting cleft lip and palate requires a skilled team of professionals.

“In addition to a plastic surgeon, you need a pediatrician to coordinate the patient’s general care,” he explains. “You also often need an ear, nose and throat doctor who can help with installing and removing ear tubes, since the ears of kids with cleft palate don’t clear fluid on their own, which can result in repeated ear infections and hearing loss. Plastic surgeons who don’t do their own bone grafting on cleft palate would bring in an oral surgeon to help with that procedure.”

More than Surgery

Other specialists might include audiologists and speech pathologists to help with hearing and speech development. Pediatric dentists and orthodontists may become involved later, around age 7 or 8. In addition, mental health professionals may help the child deal with emotional and social issues.

Buell comments, “In addition to the cleft lip and palate surgeries, I had tubes put in my ears at age 2 and taken out around age 6 or 7. At 2-1/2 years old, I started speech therapy, continuing into the 8th grade. I started having orthodontic work done at age 7.”

Inspired to Help Others

The trials she faced gave Buell a personal understanding of other children with special needs. That sensitivity led her and her mother to volunteer their services to families and schools nearby.

“I faced a lot of teasing and taunting as a child because I was different,” she says. “People would see the scars on my lip and be frightened. I was an outcast. I went to therapists, which helped, but I think what helped the most was when my mom and I started volunteering to speak with other families of children with cleft lips and palates, showing them the results and telling them they don’t have to be scared. We also talk with school nurses about how to treat children who were born with cleft lip and palate.”

In addition to her volunteer work, Buell also has worked part-time during the school year and full-time during the summer in guest relations at the Monterey Bay Aquarium.

Buell’s experiences helped transform her from a shy child to a confident and outgoing young woman who entered the University of Northern Arizona this fall to pursue a degree in hotel and restaurant management. “The care that Dr. Wu and the other doctors provided really helped get me through some tough experiences,” she says. “It’s important for people to know that physical problems like cleft lip and palate can be fixed, and there’s a great outcome.”