Stories from the Road: Microtia Reconstruction in Cambodia

Sheng Zhou, MD, Amit D. Bhrany, MD, Sam P. Most, MD, and Kathleen C. Y. Sie, MD, on behalf of the Humanitarian Efforts Committee 

Sheng Zhou, MDThe effort to provide facial reconstructive surgery in Cambodia started in 2006 as a partnership between Craig S. Murakami, MD, then of the University of Washington, and Dr. Theavy Mok, the first plastic surgeon in Cambodia. Since 2015, Sam P. Most, MD, facial plastic surgeon at Stanford University, has taken the lead of the American team. Working through the Khmer-Soviet Friendship Hospital, this outreach program has provided access to complex craniofacial surgeries with an emphasis on microtia reconstruction. In addition to providing clinical care, the American team worked with Dr. Mok as he established the first Cambodian plastic surgery residency training program.

This work led to the creation of Northwest Medical Volunteers (NWMV) in 2017 to provide medical training and assistance in plastic and reconstructive surgery to underserved communities. NWMV now collaborates with Smile Cambodia and the Standish Foundation to provide outstanding culturally sensitive complex facial reconstructive surgery. Smile Cambodia is a founding member of Smile Asia focused on treating facial deformities. They provide support for the families to travel to Phnom Penh where they first learn about the surgery from previous patients who have had microtia repair. They are critical to publicizing opportunities for microtia care in Cambodia. Founder Andy Standish and the Standish Foundation bring essential child life services to the patients to educate, empower and support families and children during this sensitive time. These collaborations, in addition to leadership from attending faculty from Stanford University and the University of Washington, are critical to the program’s sustainability.

Location and Need

Modern Cambodian history is marked by the consequences of the Khmer Rouge, which ruled Cambodia from 1975-1979. During this time, a purge of Cambodia’s educated class occurred resulting in the mass murder of academics including doctors. As a result, there remains a gap in subspecialty care and training. This longitudinal outreach helps support exposure of local plastic surgery residents to complex reconstructive cases in addition to providing access to care for many Cambodian children and adults. 

Clinical ImpactSurgical team from Stanford University, University of Washington, and MultiCare Health System finishing a case with assistance from local anesthesiologists.

In January 2025, the outreach trip began with Smile Cambodia’s Family Day. Sponsored in partnership with the Standish Foundation, it brings together children who are about to go through microtia reconstruction with previous patients. These efforts highlight the important role that the Standish foundation and Smile Cambodia play in the success of this outreach visit.

Over four operative days, 12 first-stage and 11 second-stage microtia reconstructive (autologous) procedures were performed. Stage 1 consists of cartilage framework inset in the soft tissue bed. Stage 2 involves elevation of the framework and skin grafting of the postauricular area. Additionally, 30 other reconstructive surgeries were performed. Throughout the screening and surgical process, collaboration between local volunteers, child-life, nursing, scrub techs, pediatricians, emergency room doctors, and surgeons was critical to ensuring the patients had an outstanding clinical result.

Celebrating Dr. Babaoff's birthday and expressing gratitude for his tireless work.In addition to surgical expertise, focus was also placed on bringing universal protocols and quality measures to the forefront of care. This emphasis on quality is best highlighted by Dr. Arash Babaoff and his work. As a pediatrician with extensive global medicine experience, he played a critical role in screening surgical candidates, getting patients ready for the operating room, and ensuring a safe transition out of the recovery room.

As a member of the Standish Foundation, he partnered with Andy Standish to create a child- and family-centered approach to care that increased family engagement and helped cultivate positive coping techniques among the children.

In addition to providing clinical care, we placed strong emphasis on mentorship and capacity-building for local trainees. Given Cambodia’s history and the loss of an entire generation of physicians during the Khmer Rouge era, supporting education and the development of local expertise remains essential. Throughout the trip, local plastic surgery residents assisted in the operating room, and we worked closely with the local anesthesia teams. A particularly meaningful example is Dr. Daly, now a chief resident, who first joined our missions as a medical student observer. Her growth into a leadership role reflects the long-term impact and purpose of this work.

This is a partnership that has stretched across two continents and nearly two decades. It brings together some of the most experienced microtia and craniofacial surgeons in an international model of care that puts clinical excellence and mentorship at its center.

Team members from anesthesia, child-life, nursing, emergency medicine, pediatrics, plastic surgery, and otolaryngology.

After the reign of the Khmer Rouge and Cambodian genocide, only 29 physicians survived to serve the entire country. Cambodia was not only left with a generational void of physicians to take care of their people but also to train future physicians. Our goal is to help bridge this gap by providing healthcare and educating Cambodian medical students, residents, and surgeons in order to sustain the care we provide for the short period of time we are there. In addition to providing lectures to the Cambodian medical students and residents who focus on facial reconstructive surgery, the Cambodian surgeons and trainees operate with us with the goal of gaining the skill to perform these procedures independently as we continue to return on an annual basis.

The scope of the impact is not limited to the people of Cambodia. One could argue that just as much of an impact, if not more, is made on the individuals who serve on the trip. The trip is a reminder why we chose medicine as a profession, that each of us can make a difference, and that a life serving others is a life worth living.

Details

Requirements: Please visit the NWMV program website for the most up-to-date information.

Typical Service Commitment: One week per year

Clinical Emphasis:

• Facial Plastic and Reconstructive Surgery
• Pediatric Craniofacial Surgery

Financial Aspects: Travel costs and living expenses. Unlikely to exceed USD $2,000 in total for one visit, depending on air fares.
Language Skills: English, Khmer is helpful
Global Region: Asia
Research Opportunities: Clinical

Services Provided:

• Microtia
• Cleft lip and palate
• Tessier cleft reconstruction
• Cleft rhinoplasty
• Head and neck surgery 

Coordinator Contact Information

Name: Dr. Sam Most, Dr. Kathleen Sie, Dr. Craig Murakami, Dr. Amit Bhrany
Email: NWMV@nwmedicalvolunteers.org
Phone: +855 023 211405
Address: Youtheapol Khemarak Phumin Blvd (271), Phnom Penh 12306
Website: https://nwmedicalvolunteers.org/contact

For more about NWMV and other humanitarian efforts campaigns happening around the world, visit the AAO-HNSF Humanitarian Efforts online repository of information and resources.