Air Force doctor creates faces of change

Published July 26, 2011
By Capt. Korry Leverett
455th Air Expeditionary Wing

BAGRAM AIRFIELD, Afghanistan -- For many of the wounded Soldiers, Sailors, Airmen and Marines in Afghanistan the injuries they have suffered change their life forever, but one doctor at the Craig Joint Theater Hospital has made it his mission to support those who need it most.

Air Force Lt. Col. (Dr.) Carlos Ayala, 455th Expeditionary Medical Group, chief of Ear Nose Throat, Facial Plastic Surgery, serves as the only ENT surgeon who specializes as a facial plastic surgeon in the country of Afghanistan.

"My role here is to provide care to local nationals, Afghan National Police, and our U.S. service members who have been injured in battle," he said. "I deal with their facial injuries, fractures and all types of head and neck trauma using my training in esthetics and reconstruction to allow people to go home as normal as possible."

Ayala arrived at Bagram Airfield in mid-May and in that time has already seen more than 100 patients and conducted more than 200 surgeries. He said this is the most active he's ever been.

"This is by far the busiest I've ever been in the military ... there's nothing like this," Ayala said. "The type of trauma we see here doesn't exist stateside; the injuries are not in textbooks ... yet."

Often, patients who have been in devastating Improvised Explosive Device blasts arrive with multiple fragments and soft tissue injuries to the face he said. When they arrive at the hospital Ayala and his team works to remove the fragments that would cause long term scarring if the objects remained embedded in the patient's tissue and they repair soft tissue injuries to restore their facial appearance.

Being the only facial plastic surgeon in Afghanistan, Ayala has seen a multitude of injuries in a relatively short period of time.

"We deal with mandible fractures, neck wounds, problems with a patient's airway and breathing and facial burns," he said. "Here we can restore a Soldier's appearance and facial function so they can return home as normal as possible."

Ayala said that the injuries are so unique and devastating that there are no textbooks to show him how to fix the neck and facial trauma he sees ... you have to fall back on your training, he said.

"After I arrived, I helped a little Afghan girl with diabetes that was intubated for a lengthy period of time," Ayala said. "Her voice box closed up and she would have been dependent on a breathing tube the rest of her life had I not had the necessary training and been able to save her."

This is just one surgery of many the doctor says has been successful because of the training he received at the schools such as the David Geffen School of Medicine at UCLA, Harvard Otolarygology Residency Program (Mass Eye and Ear Infirmary), and the Lasky Clinic in Beverly Hills, Calif.

"The training I've received at these fine institutions has allowed me to be here to help our service members most of all," he said. "It was my professors and teachers that brought me to this point. I'm very gracious and thankful to be able to use my training to help our nation's heroes; this is what it's all about."

Understanding the importance of training, Ayala is also involved in the Afghan Trauma Mentorship Program. The program is supported by Operation Medical Libraries, which allows Ayala to serves as a liaison between the UCLA Medical School Alumni Association and physicians here in Afghanistan.

"Supporting the COIN (counter insurgency) program we've worked out a relationship between UCLA and physicians here in order to provide medical textbooks," Ayala, who is deployed from Nellis Air Force Base, Nev., said. "This is just one of several programs which allow me to work with other physicians so when we leave this country they will be able to continue providing needed care."

When the time does come for Ayala to redeploy he will take with him a wealth of knowledge and experience to continue doing what he loves most; supporting those heroes that have sacrificed so much and providing outstanding facial plastic surgery care to all his patients.

"My hope is to continue to work with the Las Vegas Veterans Hospital collocated at Nellis AFB to take care of these soldiers," he added. "I want to be able to see their care through to the end, until they're home. I truly believe that this will always be a part of my life."