Mission Face to face: eight surgeons, one week and 25 patients who need their faces back

Serhiy Gramenko, a defender of Zmiyny, whose nose was broken twice in captivity, became a participant in the American Face to Face mission, which reconstructs the faces of Ukrainians affected by the war. Thanks to it, he can breathe again and like himself in the mirror.

Liga.net talked to Serhiy, visited the operating room, and learned how Ukrainian soldiers are given facelifts.

A hospital corridor: pale green walls, wooden boards nailed to them, a few benches, and a row of old, shabby white doors—an ordinary hospital. But some of the doors have yellow sheets of paper taped to them with inscriptions in English: room 1, room 2, room 3. They look unnatural here.

These sheets appeared here just a few hours ago — because this morning the Face to Face mission arrived at this Lviv hospital for a week. This is a project of American plastic surgeons who, since the beginning of the full-scale invasion, have been coming to Ukraine and, together with local colleagues, performing facial reconstruction operations on people affected by the war. In total, there have been five such missions and 145 patients in more than three years.

It's around 8:00 AM, and everyone is getting ready to start the examination. The doctors decide that the first two rooms will be for patients with jaw injuries, and the last room will be for patients with eye injuries. There is already a line of people with disfigured faces in the hallway.

The examination begins. Each patient takes about 10-15 minutes. People in the corridor gradually get to know each other and tell how they were injured.

"If you're a soldier, you're a soldier. And if you're a lohoped, you're a lohoped," the man without one eye sums up his story. He was injured by an instructor who decided to prove that an anti-tank mine doesn't explode under a person. The instructor was wrong.

From the examination rooms, you can hear Ukrainian and English alternating phrase after phrase. No one speaks much here — a sentence, two at most, so that the nurse translators have time to explain the patients' complaints to the doctors, and then vice versa.

In the queue for an examination, someone is laying out their scarf on the phone, someone is complaining that they are waiting too long, and someone has just arrived and does not yet know where to take their documents to register at the hospital.

Ordinary hospital patients walk along the corridor, curiously peering into the cracks of the examination rooms. They don't understand what's going on. Wives lead their blinded husbands by the arm to the area where patients with eye injuries are admitted.

"And I'm not ashamed of my wound. Should we be ashamed of war? These are its consequences," a man in a black T-shirt and sweatpants, sitting on a bench, convinces others that they shouldn't hide their wounds, no matter how severe they are.

Snake – captivity – liberation

There is a man sitting in the queue for examination room 2. His face is intact, but his nose is badly damaged – it is irregularly shaped, the nose is tilted to the right, there is a large hump below the bridge of the nose. He is dressed in black sweatpants and a gray fleece jacket. He is tall, broad-shouldered, athletic – he looks like a marine.

In fact, it is. This is Serhiy Gramenko, a marine from Zmiiniy Island. He suffered a facial injury in Russian captivity when he was beaten and tortured. He has been waiting for his turn for about an hour.

He doesn't like sitting in the corridor: he's constantly running to his desk or outside for a smoke break. He asks his friends to pick him up, suddenly it's his turn. He's not worried, he just doesn't want to sit here, leaning against the cold hospital wall.

That's why we're talking to him in his room. Serhiy is friendly, offers coffee and cookies, and is happy to tell his story.

Serhiy joined the army as a contract soldier in 2018. At that time, he traveled to the ATO zone several times. Then he became a marine and served in his native Odessa. And in December 2021, they were sent to Zmiiniy Island.

"That day (February 24, 2022. — Liga.net) we were woken up by an alarm at two or three in the morning," he recalls. "From the news, we learned that the enemy was shelling all of Ukraine, and Russian columns had already entered the Kharkiv and Kherson regions."

Serhiy, his comrades, and the command understood that the attack on Zmiiniy was only a matter of time. But they were not going to give up.

So when the cruiser "Moscow" approached the island and offered to surrender, Sergei's commander Roman Gribov said the legendary phrase: "Russian warship, go f*** off."

Serhiy recalls: in response, the Russians began shelling them with everything on the cruiser. Later, they raised the aircraft and added bombing. "We did not want to surrender, but we ourselves could not resist this onslaught," he says.

When a landing party landed on the island, the commander nevertheless decided to surrender – to save the lives of the personnel.

First, Serhiy was taken to Sevastopol. Then there were almost two years of captivity and constant transfers: Simferopol, Shebekino, Stary Oskol, Valuyki, Kursk, Mulino, Kursk again and Vyazma. Somewhere he was held for a few days, somewhere for a couple of months, and somewhere he spent more than a year.

Prisoners were constantly moved around so they wouldn't get used to each other. Even within the prison, cellmates were constantly changed so they wouldn't have time to become a support for each other.

But a new place also means new pain – "upon arrival, they immediately beat you severely so that you understand what awaits you." During such "greetings," Serhiy's nose was severely broken several times. Since then, it has acquired a strange, irregular shape, and the man has lost the ability to breathe with it and smell.

The torture continued every day: the Russians beat him with electric shocks or batons. They fed him some kind of porridge on water, without salt — "so all the prisoners were very hungry." During his captivity, Serhiy lost about 45 kilograms.

And every week, interrogations are conducted to make the prisoners "remember" what war crimes they committed. The Russians do this to reclassify prisoners of war as war criminals. Then they can be tried under Russian law and will not be subject to exchange.

Serhiy, who was captured on February 24 on a small piece of land somewhere in the middle of the Black Sea without civilians, had nothing to invent. But he went to the ATO several times in 2018 – "and I had to invent that I was looting or killing civilians then."

This happened from place to place. Each time, Serhiy hoped that he would be taken on an exchange, but in reality it only happened after almost two years.

"Already on the bus that was taking us towards the border with Ukraine, the Russians finally said that there would be no second time. If we were captured again, we would be considered terrorists," says Serhiy. "And this was not just intimidation, they forced us to sign the relevant documents."

Thus ended 679 days of captivity and began new hundreds of days of rehabilitation. Several of them were in Lviv. Serhiy submitted his application to the Face to Face mission, which restores facial parts for people injured by war. He wanted to heal his broken nose so he could start breathing again.

Eight surgeons and eight nurses

The last time eight doctors and eight nurses came from the United States to Ukraine was in May 2025. Then, as part of the Face to Face mission, they performed surgeries on 25 patients. Serhiy was one of them.

During the mission, doctors performed surgeries to reconstruct the nose and parts of the jaw, as well as surgeries to place implants to restore the shape of the face. However, the main focus of the mission is surgeries to restore the upper or lower jaw. During these, a part of the bone is cut from the patient's leg or arm and transplanted into the face.

These are complex operations, because they are performed several months or even years after the injury, and doctors often have to redo what surgeons have hastily done at the stabilization center. There is no time or opportunity to think about the aesthetic side or even about the comfort of the patient – the face is sewn up so that the person simply survives. Often after such operations, the wounded cannot speak normally, food may fall out of their mouths or water may spill out.

"There are actually a lot of such patients, thousands of them," says ENT doctor Ivanka Nebor, a member of the mission from the American side. "We are trying to do everything possible to help as many as possible. But no matter how many missions come, Ukrainian doctors still have to deal with this." Ivanka studied in Ukraine and worked for a year at the Institute of Otolaryngology in Kyiv, but five years ago she went to the United States.

The surgeries are quite expensive, as patients are fitted with special titanium implants that replace the damaged part of the jaw. This is an expensive material, but it does not cause a rejection reaction.

Face to face also brings with it medicines, tools and equipment. And all this remains in the state hospitals where the mission takes place. The missions are supported by the organizations Razom for Ukraine and INgenius.

"We don't want our mission to take anything away," says Ivanka Nebor. "On the contrary, we try to give as much as possible."

F*ck Putin, is that you?

"Sergei Gramenko, come in!" the nurse's voice is heard from examination room 2.

A man enters the office. Old wooden chairs, the same table, an advertising calendar on the wall and a red rug with mysterious patterns. This is an ordinary office in an ordinary state hospital. The only difference: now the world's leading doctors see patients here

"Do you need a translation?" asks the nurse-translator. She is also a member of the mission from the American side. There are about ten people like her. These are ethnic Ukrainians who currently live in the United States, so in addition to medical work, they also help with translation.

— Yes, — Serhiy answers and continues: I was in captivity for two years. My nose was broken several times there. Because of this, I can't breathe through it, only through my mouth. And I also can't smell. And I would also like to remove the hump and correct the shape so that it would be beautiful.

"Wait, not all at once," the nurse politely asks. "Give me a little at a time so I can translate."

She explains everything in English to the two American doctors, but also adds that Serhiy was at Zmiyinoye, and that's where he was captured.

— F*ck you Putin! — foreigners say almost in unison when they hear about Zmiiniy. They may not have translated this legendary phrase exactly, but they know exactly what it means. Their eyes show respect for Sergei.

"It was my department commander, Roman Hrybov," Serhiy answers with a smile.

"Which side of the nose breathes better?" the doctor asks.

"None of them are breathing."

For several minutes, the doctors chat about Serhiy's injury. They speak quietly and mostly exchange medical terms that almost no one understands except themselves.

"This is captivity, anything is possible there," the nurse-translator summarizes the conversation.

"Do you smoke?" the doctor asks.

— Yes.

— You need to stop, at least before the surgery and two to three weeks after it. If you continue, the nose will take longer to heal after the surgery.

— Can we at least use electronic cigarettes or something like that?

— No, the problem is nicotine. It constricts blood vessels, and this will affect the speed of recovery after surgery. Therefore, it is not allowed.

"You need to stop smoking. Right now," the doctor adds after a pause. "We can give you a nicotine patch if you're having trouble quitting. It's still harmful, but not as bad as cigarettes."

Serhiy refuses. He is sure that not smoking for a few weeks is not such a difficult task: "When I was in captivity, I went without cigarettes for two years, and I managed nothing – there was no choice. Now I will have to too."

After the operation, there will be a plastic retainer on the septum, a splint will be placed in the middle of the nose, and stitches will be placed under it. They will dissolve on their own in ten days. The doctors explain to Serhiy what awaits him, and warn that after the operation, it may be harder for a while. The first two weeks, the congestion may become worse, the eyes may swell – "this is normal, don't be afraid."

— Will any seams be visible?

"No, nothing. Everything will be inside the nose."

"And this hump will disappear?"

— Yes, and they will also move your nose to the right so that it is more symmetrical.

They then continue to discuss the shape of the nose, what it should be like after the operation. It may seem that the man does not want to lie down on the operating table and is even a little afraid of the operation. But in reality, he is not.

"I'm only excited about the result," explains Serhiy. "I want everything to be done well. So that I can look in the mirror and see the same old me."

When he returned from captivity, there was no time to worry about his appearance. His family and friends were simply happy to see him alive and did not notice any changes in his appearance. Serhiy immediately began rehabilitation and paid little attention to his broken nose.

But deep down, he still wanted his face to be the same as before. That's why he bombards the doctors with questions.

— Your surgery will be performed by Dr. Abraham Manoj and Vitaly Panchenko. One of them is an American plastic surgeon, the other is Ukrainian.

— Why two?

— That's how they always work, they'll help each other.

— Won't it be that one person does the first half of the operation, and the other the second?

"No, of course not," the nurse replies with a smile, adding: "You have surgery on Thursday, you can be free now."

Shin, jaw and rock and roll

The Face to Face mission operates in three operating rooms. Before you get to them, you have to go into a large room. There are tools, medicines, a sink, some equipment, and three doors, each of which leads to a separate operating room. At the entrance to each of them, yellow sheets with English inscriptions are again hanging, only now table 2, table 3, table 1 — in exactly that order from left to right.

In one corner of this room hangs a Ukrainian flag that turns into a US flag. Under it is special equipment for sterilizing instruments. Opposite are several suitcases completely filled with medicines — they were brought with them by American doctors. In another corner are stacked boxes with implants for restoring jaws.

On the first and second tables lie patients with identical injuries. Both are missing parts of their lower jaw. These are precisely the operations with bone grafting from the leg or arm to the jaw that Ukrainian doctors cannot yet perform on their own. On the third table is a patient who will have his eye restored.

Inside each operating room, there is another yellow sheet on the window with the title Time Out — a list of information that needs to be checked before the operation: first and last name, date of birth, whether the patient has any allergies, what kind of operation they will be having, what antibiotics will be prescribed after it, and other questions.

The doctors take turns going over all these points. Then the operation begins.

In fact, preparation for the surgeries begins four months before the mission to Ukraine. First, doctors select the patients who will undergo surgery, ask them to take a CT scan of the damaged part of the bone, and based on these images, they make 3D models and design implants.

"This is a very painstaking and time-consuming job," says Ivanka Nebor. "A doctor and an engineer design the implant. One implant requires about five sessions (meetings between a doctor and an engineer — Liga.net), each of which lasts over an hour. And on average, we install 10-15 implants per person. That's how many parts the part of the jaw that we restore consists of."

But now these titanium implants are already in the Ukrainian operating room. Above them hang printouts – a model of the skull and the different implants that will be used to restore the jaw are highlighted in color.

The operating room is filled with doctors, American and Ukrainian nurses. The first are already working with the patient. The second are helping with translation, and the third is just interested in watching what is happening. Although in reality, each has their own job and performs it, running between operating rooms.

There are so many people that it is already difficult to understand where the American and Ukrainian doctors are. Moreover, they are all hiding under disposable masks, blue caps and overalls. The only thing that distinguishes them from each other is their shoes. Ukrainian doctors wear Crocs, American doctors wear sneakers.

"This is all because in American clinics there is a rule – shoes must be closed. And here it is the opposite – shoes must be changeable, that's why we choose comfortable Crocs that are quick to put on," explains Vitaliy Panchenko, a Ukrainian plastic surgeon.

The doctors are working in two groups. The first is performing surgery on the leg. They have already made an incision and are preparing to cut out part of the shin bone. It, along with the tissue and blood vessels, will be transplanted to the face.

The bone will be placed on implants, and the vessels will be connected to the vessels of the neck, thus restoring blood supply and the shape of the face. Another team prepares the patient's face: they make a special hole to insert the implants and transplant the bone.

Such operations usually last about 10-12 hours, so only about eight can be completed in one mission.

Despite the complexity of the process, laughter sometimes rings out from the operating rooms. True, it's not the operating doctors who are laughing, but their colleagues who are still waiting for their turn.

Music is playing from the speakers in the operating rooms. In the operating room, table 2, TNMK and Boombox are playing, and in the other, table 1, Queen and Ricky Martin. Both Ukrainian and American doctors admit that music in the operating room is a common practice.

"After one of the most difficult operations that we had this time, our colleagues turned on We are the champions," says Vitaliy Panchenko. "The operation lasted over 15 hours, it was difficult. But it was nice to hear such a song at the end."

But even this does not help to cope with fatigue. At the fifth hour of the operation, the doctors began to go out for a lunch break. It lasts no more than 10-15 minutes. Those doctors who are not currently involved in the operation go out, the others continue to work despite their fatigue.

The doctors have lunch in the nurses' room, 30 meters from the operating room. There they are served soup, salad, fish or chicken of their choice, and pickles. Not understanding what it is, most of them do not dare to try it.

In general, most people prefer the first one — pureed soup. It's the easiest to eat, just sip a few spoonfuls. They simply don't have the strength for anything else.

"Can you imagine, there are people who run 25 kilometers. How do they do it?" one of the American nurses asks her foreign colleague, to break the silence in the room.

"Running is not standing. It's harder," the doctor answers dryly.

The room is silent again, and there is a growing sense of fatigue in the air. Ten minutes will pass, and they will be back—to stand for another five or six hours, giving people their faces back.

After surgery, patients will be able to open their mouths, chew, and drink again. The ability to speak will improve. And of course, it will return a more familiar face shape.

Although during such operations a part of the bone is cut out of the leg, the patient does not experience major changes. He needs special rehabilitation, but after that he can stand, walk and even run – "not a marathon or a football match, but he can run."

Restore your breath and appearance

Serhiy's operation is different and much simpler. It is called rhinoseptoplasty. "We could have done such an operation ourselves. This is what I specialize in," says doctor Vitaliy Panchenko. "But Serhiy wanted to be operated on by American doctors. And they, having heard his story, could not refuse."

During the operation, Serhiy had part of the bone that forms the nasal septum removed. It was crooked and could not be straightened. The bones that form the wall of the nose were also removed and filed. The operation lasted about four hours.

"When I woke up after anesthesia, I was surprised that I didn't see any stitches," says Serhiy. "They were all hidden inside the nose, nothing was visible from the outside. And the hump had disappeared."

The first time after the operation, as the doctors had warned, was difficult. At first, blood flowed constantly from the nose. Later, although breathing and the sense of smell were restored, a constant feeling of dryness appeared in the nose. It still bothers the man, more than two weeks later.

"Maybe it's because I never quit smoking," admits Serhiy. Despite doctors' advice and his own promises, he was only able to reduce the number of cigarettes he smoked daily by a third.

Serhiy often mentions American doctor Abraham Manoj, thanks to whom he can breathe normally and smell again.

"During the last examination, after the operation, I presented the doctor with a ribbon in the colors of the Ukrainian flag with the coat of arms and a caption in English: To Doctor Abraham Manoj from the defender of Zmiiniy Island," says Serhiy. "I am truly very grateful to him."

And although Serhiy still needs some time to fully recover from the surgery, he has already left Lviv for Uzhhorod. He will be receiving back treatment for several weeks: physical therapy, massages, and electrotherapy.

Then he will return to his native Odessa. "But I have already found a place there where I will go for rehabilitation," Serhiy says in a serious tone. He does not know when he will be able to fully recover from captivity, so he does not want to speculate about what his future will be.

"I haven't even started thinking about what I'll do next. Right now, my health comes first, and I'll figure out everything else later," says Serhiy.

The material іs produced by Lisa.net with Askold and Dir Fund as a part of the the Strong Civil Society of Ukraine – a Driver towards Reforms and Democracy project, implemented by ISAR Ednannia, funded by Norway and Sweden. The contents of this publication are the sole responsibility of Lisa.net and can in no way be taken to reflect the views the Government of Norway, the Government of Sweden and ISAR Ednannia.