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Dr. Ian Hoppe examines Scotty Virak's nasal area while Scotty's mother, Alli Mellon, and his grandmother, Barbara Mellon, watch.
Dr. Ian Hoppe examines Scotty Virak's nasal area while Scotty's mother, Alli Mellon, and his grandmother, Barbara Mellon, watch.

Child travels from Cambodia to undergo complex plastic surgery

Published on Thursday, December 19, 2019

By: Annie Oeth, aoeth@umc.edu

Born with a bilateral cleft lip and palate and a cleft on the left side of his face, Both “Scotty” Virak was abandoned as a newborn in the crowded city of Phnom Penh, Cambodia.

“The authorities contacted me and said they had this abandoned baby, but our organization wasn’t ready to take a baby yet,” said Alli Mellon. “We were planning to open a children’s home but not until spring. I couldn’t turn him away. I knew he was meant to be mine.”

A Clinton native, Mellon is founder and executive director of The Hard Places Community, a nonprofit that helps children in Cambodia, Greece, Madagascar and India escape trauma, human trafficking and sexual abuse. She lives in Cambodia. 

Scotty-Virak-before-2.jpg
Scotty is shown before the surgery that repaired his cleft lip and facial cleft on May 6. Cleft palate surgery followed Dec. 9.

Surgery to repair those clefts brings the two nearly 15,000 miles to the University of Mississippi Medical Center and its pediatric arm, Children’s of Mississippi. Dr. Ian Hoppe, who heads pediatric craniofacial plastic surgery at UMMC, has performed two repairs on Scotty, who was adopted by Mellon.

“He is a beautiful surprise who brings joy and love to our family every day,” said Mellon, who has also adopted two 10-year-old girls, a 6-year-old boy and a 5-year-old girl.

Scotty’s recovering nicely from palate surgery Dec. 9 that is allowing him to have an easier time eating, said Hoppe, “I performed a repair to his lip deformity earlier this year,” Hoppe said. “We normally proceed with closure of the palate around a year of age, and in that surgery, we addressed his nose. He may need a larger reconstruction for that abnormality later in life, but he’s doing very well now.”

Children’s of Mississippi, which includes the state’s only children’s hospital, has the state’s only Pediatric Craniofacial Center certified by the American Cleft Palate-Craniofacial Association.

Scotty Virak looks at a nurses ID badge during a follow-up visit at Children's of Mississippi's Eli Manning Clinics for Children.
Scotty looks at nurse Kevin Nelson's ID badge during a follow-up visit at the Eli Manning Clinics for Children.

 

ACPA certification requires a multidisciplinary team including a surgeon trained in transcranial cranio-maxillofacial surgery, a neurosurgeon, a psychologist for neurodevelopmental and cognitive assessment, an ophthalmologist, a social worker, a geneticist, a speech therapist, a dentist and an orthodontist.

“The depth and breadth of knowledge required for ACPA certification are wide, and their standards are high,” Hoppe said. “Having the resources of an academic medical center means we can offer the complete spectrum of care needed by patients born with cleft lip and palates and complex facial clefts.”

Children born with cleft lips, palates and facial clefts may have issues with breathing and feeding, and later, with speech. Patients with rare clefts that involve the eye also need ophthalmology care.

About one in every 1,600 babies is born with a cleft lip and palate, according to the U.S. Centers for Disease Control and Prevention. Complex facial clefts are very rare and their prevalence is not well understood.

Visiting Hoppe for follow-up care in December, a nearly 1-year-old Scotty was wearing sneakers, khakis and a thick cardigan.

“He’s not used to being bundled up,” Mellon said. “Temperatures in Cambodia are usually in the 90s.”
Bundled up for December weather in Mississippi, Scotty is used to warm weather in Cambodia.
Bundled up for December weather in Mississippi, Scotty is used to warm weather in Cambodia.

To get to this latest visit, Mellon and Scotty flew from Phnom Penh to China, then to Los Angeles, where they had a 12-hour layover, and then to Nashville for a visit with her sister, Lisa. The trip usually includes about 30 hours of flying time.

“We watch movies to keep from going stir crazy,” she said of the lengthy flights.

About seven months post-surgery, little evidence of Scotty’s cleft lip remains. Since his most recent surgery, eating is easier, and Scotty is a happy, active toddler.

His first surgery, on May 6, was as a 5-month-old. “He got his stitches out May 13, and he’s done really well,” Mellon said. “He doesn’t always like to have his face touched, but he gets facial massages four times a day to help in healing.”

Mellon’s mother, Barbara Mellon, loves having her daughter and Scotty in Clinton when follow-up visits at Children’s of Mississippi are needed.

“We just love him,” she said, “and we love taking care of him. He is so sweet.”