Fresh Start Surgical Gifts: Transforming Lives Through Free Reconstructive Surgery

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. 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.