Free Reconstructive Surgery for Children

Transforming Lives Since 1991

Fresh Start Surgical Gifts provides qualifying infants, children, and teens with reconstructive surgery and related medical care at no cost to patients or their families. In San Antonio, Fresh Start partners with University Health to provide free pediatric reconstructive procedures for children with physical differences caused by birth defects, accidents, abuse, or disease. Families can apply for assistance through Fresh Start Surgical Gifts to determine whether their child qualifies for care.

Surgery Weekend

Surgery Weekends happen multiple times per year when Fresh Start’s vision comes to life and we provide children with the expert medical care they need.

Dental & Orthodontic Clinic

Dental & Orthodontic Clinics provide dental care and comprehensive orthodontic care for the surgical patients.

Support Services

Fresh Start offers a range of services to ensure that every child receives high-quality, personalized care until the best possible outcome has been achieved.

The Fresh Start Home Office

2011 Palomar Airport Road, Suite 206

Carlsbad, CA 92011

English: 760-579-9110

Español: 760-448-2012

Toll-Free: 1.888.551.1003

Fax: 760.944.1729

Angela Paduch

Angela Paduch, RN, BSN, serves as the Medical Program Manager for Fresh Start Surgical Gifts, a nonprofit dedicated to changing the lives of children in need of reconstructive medical care. Fresh Start was founded in 1991 by Dr. Dennis Nigro, a California surgeon who recognized a critical gap: children born with physical deformities often lacked access to the surgeries they desperately needed. Research shows that children with untreated deformities face greater challenges in school, social interactions, and future opportunities. Dr. Nigro’s vision was simple but powerful—give children the chance at a brighter future through access to life-changing surgery.

Comprehensive, Compassionate Care

Fresh Start accepts patients from birth through age 20, and once a child is accepted, they remain in the program until their treatment is complete—no matter how long that takes. Importantly, the nonprofit never turns away a patient due to immigration status or family income.

“We provide cosmetic and reconstructive surgery totally free of charge,” explains Paduch. Many of the procedures Fresh Start provides—such as scar revisions, birthmark removal, or reconstructive work for children born with microtia (missing an outer ear)—are often labeled “cosmetic” and denied by insurance or Medicaid. Yet these surgeries can cost families $15,000–$20,000, not including hospital and surgeon fees. Since its founding, Fresh Start has provided more than 9,000 surgeries, totaling over $60 million in donated medical care.

Partnerships and Locations

Most procedures are performed at Rady Children’s Hospital in San Diego, Fresh Start’s flagship partner. In San Antonio, surgeries are performed at University Hospital, where families have access to state-of-the-art facilities and expert medical teams. San Antonio’s program is still growing and currently hosts three surgery weekends each year. Today, Fresh Start operates in four locations: San Diego, CA; Chicago, IL; Worcester, MA; and San Antonio, TX. Children travel from across the U.S. and abroad—including Mexico, Honduras, and Costa Rica—to receive care.

Fresh Start covers all associated costs, from airfare and hotel stays to meals and transportation. Families traveling by car are reimbursed for gas and lodging, ensuring that financial barriers never stand in the way of treatment. “We want children to have a better, happier, more fulfilled life,” says Paduch. “Our goal is to correct deformities so kids don’t have to endure bullying or shame about their appearance.”

Beyond Faces: A Wide Range of Care

While many surgeries focus on facial reconstruction, Fresh Start also provides procedures such as:

Scar revisions from accidents or burns
Hernia repairs
Dog bite repairs
Treatment for boys with excess breast tissue
Laser treatments for burns
Missing or misshapen ears
Birth marks
Crossed or Shaky Eyes
Other physical deformities caused by birth defects or accidents

Each case is approached with compassion, ensuring children not only receive medical care but also the dignity and confidence every child deserves.

How to Help Fresh Start Surgical Gifts is a nonprofit where 100% of donations, grants, and fundraising go directly to patient care. To learn more or make a gift, call (760) 579-9110 or visit www.freshstart.org.