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Surgery over; Youssif's biggest scar removed

  • Story Highlights
  • Surgery takes more than three hours
  • Scar tissue removed; described as "hard as wood"
  • CNN's Arwa Damon: "Bottom part of his face looks like the old Youssif"
  • Balloons filled with saline stretched Youssif's skin over recent weeks
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By Arwa Damon and Wayne Drash
CNN
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Editor's note: CNN agreed not to use the full names of the family members in this article because of concern for their safety.

LOS ANGELES, California (CNN) -- Five-year-old Youssif underwent his most important surgery Thursday as his doctor removed the most extensive scar tissue on his face -- putting him on the path of being a normal boy again.

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The balloons placed under Youssif's skin stretched his good skin enough to cover his scars.

Youssif entered the operating room around 6:30 a.m. PT for the three-and-a-half hour surgery.

Just before the surgery began, Youssif began crying.

"I can't do this. I can't do this," he said.

Sedation then set in, he relaxed and Dr. Peter Grossman, the plastic surgeon with the Grossman Burn Center who is donating his services, began to operate.

He removed two saline-filled balloons placed in Youssif's neck and face that provided more good skin by stretching it. The largest balloon was about the size of a soda can. See Grossman's plan to remove the scars »

Grossman then cut out the scar tissue and pulled up Youssif's healthy skin.

The doctor was amazed at how thick the scar tissue was -- about half an inch thick -- and "hard as wood."

When the tissue was removed, Youssif's jaw immediately relaxed, raising hopes that he will soon be able to eat normally again.

"The bottom part of his face looks like the old Youssif. He has a jaw line again. It's unbelievable," CNN's Arwa Damon said after coming out of the operating room.

The surgery ended around 10 a.m. PT.

Ahead of the surgery, Grossman was excited for Youssif. "This will be the most significant of the surgeries," he said.

One of the scars removed extended more than half a foot, stretching from his right ear around to his left cheek.

Grossman also repaired part of Youssif's lower lip.Video Watch Youssif before, during and after his third surgery »

To reach this point, Youssif had two balloons inserted under his skin about nine weeks ago -- one in his neck and one on his right cheek. Each week since then, doctors have gradually inserted saline to blow up the balloons to stretch Youssif's good, healthy skin.

Rescuing Youssif
Watch a CNN exclusive "Impact Your World -- Rescuing Youssif" about the Iraqi boy's ordeal
Dec. 24 at 10 p.m. ET; Dec. 25 at 4 p.m. ET

Although Youssif has gradually warmed up to Grossman -- especially when compared with his attitude toward hospitals and doctors back home in Iraq, where he was never given any pain medication -- at times it took four people to hold Youssif down during his weekly inflations. But his father says that the doctor has always been kind and understanding.

Living temporarily with the balloons is never an easy process for burn survivors because they look much worse -- like a "science-fiction creature" in Grossman's words -- before they can get better.

"We try not to traumatize the patients emotionally with this too much," he said.

Youssif didn't seem to mind the blown-up balloons around his face, although he was well aware of how they made him look. Youssif was recently going down a slide on a playground when nearby children burst into tears at the sight of him, his dad said. Photo See how Youssif is changing »

"Youssif came out and his face had gone pale and he said, 'Daddy, they were crying, they were scared of me,' " the dad said.

But his parents say their boy is a much more cheerful child than he was when they first arrived in the United States two months ago. At the same time, everyone was excited that the balloons were to be gone and that Youssif's mouth may fully open again. Video Watch a giggling Youssif run, roll and ride at sports camp »

Eating his meal before being admitted to the hospital Wednesday afternoon, Youssif struggled to spoon food between his lips. He looked at his mom and said, "Are they going to fix my mouth?"

"Yes, my darling," she answered.

"When? Today or tomorrow?"

Grossman cautioned not to expect an amazing improvement in Youssif's looks immediately after the surgery. There will be a "significant difference" in his looks, the doctor said, "but right away, swelling will start to occur, and it'll distort the overall picture of how he's going to look."

But, he said, in a week or two, the swelling will subside and Youssif will "understand why he had to go through all of this." There also will be other minor surgeries later on to "tweak" Youssif's looks.

It's been nearly three months since CNN.com first reported on Youssif, who was attacked by masked men outside his Baghdad home in January, doused in gas and set on fire. CNN.com users, the burn center and the Children's Burn Foundation came to his aid, with more than $300,000 raised for his treatment.

His family is grateful for all the support and eager for this process to be over. Youssif takes it like a champ -- in many ways wise beyond his years.

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"For a 5-year-old boy, he has shown a lot of courage in this process," Grossman said. "I mean he does not like it at all. But he knows this is a necessary evil."

He added, "My hope is that I can show him that it was worth it." E-mail to a friend E-mail to a friend

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