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The Beauty Issue: The Delicate Surgical Magic of Dr. Evan Ransom

By Laura Hilgers

This story is part of a the Nob Hill Gazette’s feature, Perspectives on Beauty, in our March issue.

This family traveled hundreds of miles to see Dr. Ransom, who performed a cleft lip repair for one of the twins; the other will return for a palate surgery next year.

What is beautiful? To the mother of Gael Salazar Montenegro, it was seeing her son’s face whole.

Gael was 11 months old when he and his mother made the 22-hour journey, last April, from their remote village in the Amazon region to Ica, Peru. They came so that he could under-go free surgery by a team of American medical professionals, on a mission with the nonprofit Healing the Children, to repair a protrusion the size of a cherry between his nose and upper lip. The protrusion was the result of Gael having been born with a bilateral cleft palate and lip. Without the surgery, he’d have trouble talking or eating solid foods. He’d also face a lifetime of discrimination for his looks.

Evan Ransom, a San Francisco plastic and reconstructive surgeon, performed the three-hour-plus surgery on Gael and says that the case was one of the most challenging he’s ever seen. When Gael’s mother saw the boy’s face afterward, she broke into tears. The protrusion was gone. Her son now had a chance to live a normal life.

Gael was just one of about 80 children that Ransom and his team operated on that week, all of them with cleft chins, cleft palates or deformed or absent ears (a condition known as microtia). For children like Gael, says Ransom, this surgery can be a “life-changing experience.”

This patient underwent a cleft lip repair two years ago with Dr. Ransom. He returned with his family for a successful follow up.

“The way that I see beauty come out in my patients is intimately related to self-confidence,” says Ransom. “I want people to project to the world how they feel on the inside rather than be hung up on what they perceive as — or what society has told them — the things that don’t look right.”

Ransom, who graduated from Columbia University’s medical school, was drawn to re-constructive surgery for its beauty. “It’s probably the most satisfying, from an artistic or aesthetic perspective, of any surgical discipline,” he says. In the Bay Area, he devotes much of his practice to standard and far more lucrative cosmetic procedures, such as Botox and fillers and giving affluent women the perfect small upturned nose, a la Nicole Kidman (a favorite among his Caucasian patients). “My goal is to make people look like a slightly younger, more refreshed version of themselves,” he says.

But he also works with Operation Access, which provides free surgical care to under-served communities, and FACE TO FACE, which provides surgical and nonsurgical treatment for facial injuries resulting from domestic violence. Working with FACE TO FACE, Ransom has repaired the shredded earlobe of a woman whose ex-partner pulled out her earrings in a fight. He’s also done reconstructive surgery on a woman whose former partner broke her nose several times. For these women, beauty runs much deeper. “They will often see the injury and it’s a trigger for them,” he says. “With surgery, the emotional trauma doesn’t necessarily go away. But when you restore them to their pre-injury state, as far as that’s possible, it helps them to overcome some of the trauma and move past it. You give someone back that internal image of themselves.”

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