Picture a child with a facial tumour, genetic condition or traumatic facial injuries and put yourself in their shoes for a second. Aside from considering their frequent hospital visits and regular medications, how often do we stop and ponder upon their mental wellbeing or how they cope amongst their peers?

In efforts to better comprehend what a child in such a situation might be going through, the entertainment industry has stepped out of their fairy tale comfort zone and ventured into exposing the harsh reality of living with various facies. Take for example the recently released film ‘Wonder’ – inspired by real events – which depicts the challenges a young boy born with a facial deformity, faces in school.

Besides that, the media has also played a role in highlighting the psychosocial impact of living with facial deformities. Moving articles about the mental stressors faced by children in this situation zoom in on the effects of isolating, taunting and stigmatizing them. In the UK, children such as 11-year old Marcus have had the opportunity to detail their experiences in an attempt to raise awareness for their mental health.

Marcus, who has a cleft lip and palette, has now progressed to secondary school. Here he is pictured with his primary headteacher Ann Pritchard. Photo credit: Christopher Thomond/The Guardian
Marcus, who has a cleft lip and palette, has now progressed to secondary school. Here he is pictured with his primary headteacher Ann Pritchard. Photo credit: Christopher Thomond/The Guardian

Marcus – born with a cleft lip and palate – has had 15 operations for his condition but was unaffected by his appearance until a certain year in school whereby the children became more conscious of his disfigurement.

“It was as though suddenly they saw me differently. They called me scarface or Moshi Monster and said I was ugly and they didn’t want to play with me. Before, I had lots of friends,” describes Marcus.

His mother weighed in on the mental impact of it all saying, “I realised he no longer mentioned friends. At first, he wouldn’t tell me what was happening and when he did and I suggested talking to the teachers he said he had done and they didn’t do anything.” Other children have also been noted to retreat into impenetrable silence and erupting into rages.

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Mental challenges develop skills to evade bullies

As faces represent the primary means where people navigate minor social exchanges in daily living, verbal and non-verbal cues play a major role in affecting our thoughts. Research has shown that in casual interactions, people tend to have certain responses to those with a facial variance. These minor acts such as standing further away – or to the side – are subtle but significant.

A more obvious issue is the unwanted attention, such as rude and intrusive remarks towards the affected individual. This scene is clearly depicted in the movie ‘Wonder’ and social scientist Frances MacGregor eloquently words this reaction towards people who have a visible facial variation.

“The ‘civil inattention’ that is normally conferred by strangers on one another and that makes it possible to move anonymously and unhindered in public spaces is a right and a privilege most longed for by facially disfigured people who […] are victims of intrusions and invasions of privacy, against which they have little or no protection,” she explained.

Photograph of the late Frances Cooke Macgregor. Macgregor wrote many books on people of different cultures and races, and afterwards pioneered work in the field of research in facial deformities and plastic surgery. Photo credit: Hingham Public Library Local History & Special Collections
Photograph of the late Frances Cooke Macgregor. Macgregor wrote many books on people of different cultures and races, and afterwards pioneered work in the field of research in facial deformities and plastic surgery. Photo credit: Hingham Public Library Local History & Special Collections

Ironically, some studies conducted in the UK surrounding this topic have shown that adolescents with cleft lip and palate or a craniofacial condition faired better on some measures of body image and wellbeing compared to “normal” children.

One notable reason is that these children regularly face such challenges and – with adequate support and the right mindset – therefore, have developed methods of tackling socially uncomfortable situations. For example, they are able to use humour to divert the conversation or addressing their deformities early during social interactions. On the contrary, these results could also depict the growing psychological effects of body image dissatisfaction amongst the “normal” young for various reasons.

Can support for plastic surgery in children help?

As depicted in ‘Auggie’, these facial differences can have a big effect on one’s life – equivalent to losing a limb or a chronic condition. In instances as such, the role of plastic surgery is valued as children can restore facial appearances to lead a normal life.

When pushed to the extent of social withdrawal, some parents fear the safety of their children and are convinced that surgery is a worthy investment for their child’s happiness. Plastic surgeon Joe Niamtu, who practices in the US, recently performed plastic surgery on Bella Harrington, an 11 year-old with protruding ears and claims he even works on children aged 4 years old.

Bella underwent an otoplasty surgery to pin her naturally protruding ears backwards. Photo credit: DailyMail
Bella underwent an otoplasty surgery to pin her naturally protruding ears backwards. Photo credit: DailyMail

“Even small facial deformities can produce very negative psychological consequences in childhood that can lead to a lifetime of low self-esteem and negative body image,” he justifies.

Additionally, with the growing occurrences of suicide amongst the young in this day and age, charities such as Changing Faces in the UK have stepped up to support the visibly different and to counter prejudice. Jane Frances, policy adviser for the charity, speaks of the huge effect of appearance bullying and the damage it does to children’s education. To overcome this, teaching resources to educate other schoolchildren and teachers have been introduced by this organisation.

“With today’s emphasis on appearance, it is more important than ever that schools have a way of confronting staring, comments, questions, ostracism and bullying,” Frances elaborates. “Without appropriate intervention, it so easily affects vulnerable children’s wellbeing and achievement.” MIMS

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Sources:
https://www.theguardian.com/education/2015/oct/19/appearance-bullying-children-facial-disfigurements-body-image
http://www.dailymail.co.uk/femail/article-5447423/11-year-old-girl-cosmetic-surgery-elf-ears.html
https://theconversation.com/children-with-facial-difference-have-a-lot-to-teach-us-about-body-image-90693
https://www.bustle.com/p/wonder-isnt-based-on-a-true-story-but-the-new-dramedy-will-still-break-your-heart-5467639