a lot of the kids just make fun of me, how i look. i can't really leave the house ever. i don't want people to see me. >> reporter: they say beauty is only skin deep. >> that's not what makes a person, a person. >> reporter: but try telling that to kids who are laughed at and bullied. >> he said, "donovan, why don't you just go kill yourself tonight?" >> i know it's hard sweetie.

>> depressed, hiding from the world. >> they wouldn't like me for how i look or how large my nose is. >> reporter: now, a program that uses surgery as a way to stop the bullying. >> it would probably change my whole life, in a good way though. >> reporter: it's a controversial step. doesn't that put the burden on the victim as opposed to the bully? tonight, will four teens choose a drastic solution? >> how does it feel to be beautiful? >> reporter: or learn to put on a brave face? >> the bully's going to be left in the dirt. >> reporter: i'm lester holt and this is "dateline". here's hoda kotb with "second chances". reporter: their lives would be a complete mystery to us if we weren't sometimes haunted by our own teen years. the pressures to fit in. the anguish to be understood. it's a time when we first learned that we could be alone, even with people all around us.

>> most of the people that have like, called me names are sitting over in the corner. >> they would say i'm ugly. they would laugh behind my back. it was really bad at school. >> people don't think jocks get bullied or teased, but my case i guess is different. >> reporter: these teens say they've been picked on, laughed at, even physically harassed. and they all blame the bullying on one thing, their looks. >> either like refer to me as some animal or like a bird with a beak or something, like making fun of me. >> they were just calling me, "that girl with the big nose." >> why don't you have a chin? just go get a chin. buy one at walmart or something like that. >> reporter: so in an attempt to silence their bullies, and rebuild their shattered self-confidence, they've all decided on the same extreme course of action. and we'll follow every step of their controversial pursuit. one with physical risks and psychological uncertainties. >> i just really need help.

>> reporter: we begin their story with this girl from south carolina, named renata. >> a lot of the kids just make fun of me, how i look. it just really hurts, and you can't get over it. >> reporter: when we first met her, she was 14 and would spend her days almost entirely at home, watching tv or playing video games. >> she has no friends. she keeps to herself. she's just missing out on things that can never be replaced later on. >> reporter: but renata's mom michelle says it wasn't always like this. describe her back then, what kind of a little girl was she? >> very outgoing. she had a ton of friends. she was involved with different social activities. >> reporter: including beauty pageants. renata competed in a few of them when she was eight. now what made you interested? >> i just liked dressing up and being pretty. and i liked being in front of people. >> reporter: but by the

6th grade, something happened to renata. >> she became more quiet. more and more withdrawn as months went on. i asked her what was wrong. she would say, "nothing's wrong, nothing's wrong." >> reporter: renata resisted going to school, complaining that she felt ill each morning or that she wasn't learning anything in class. after months of struggling, michelle decided to home school renata through online classes. >> i didn't want to see her come home from school every day and be unhappy. i don't want to see my child unhappy. >> reporter: but it took renata two more years before she finally told her mother the truth. she didn't want to go to school because some classmates had teased her about her nose. they would call her ugly. why wouldn't you say to your mom, "mom, look, these kids are starting to pick on me and it's getting -- it's really -- i'm getting depressed?" >> well, i thought if i told her, she would just go to the school. and then that'd make more problems. >> reporter: did you think maybe what they're saying is true? >> uh-huh.

>> reporter: you were in pageants. same face, girl. why can a kid change your mind about who you are, do you think? i know it's hard, sweetie. i know it's hard. >> reporter: renata was so depressed by age 13, she would hardly leave the house. when her mother made an appointment for her to see a mental health counselor, renata refused to go. by then, she had decided there was only one way to make things better, to change her looks through cosmetic surgery. >> every time i look at myself i just think i'm getting more uglier. i'm just afraid i'll never have any friends, or anyone to be there for me because i can't really leave the house ever. i don't want people to see me. >> reporter: while many adults unhappy with their looks turn to cosmetic surgery, it may seem like a radical response to bullying, especially for a teen who's still growing physically, and mentally.

might renata grow out of this? cause in life, we all go through phases. i hate my hair, and now it's not so bad. i thought my name was weird, now i'm so glad i have a weird name. in the beginning, i was, like, "i just want to be helen." do you wonder if this is just a phase you're going through? >> i don't think it's just a phase. i guess in a few years from now, if i didn't change anything, i would still feel the same way, because of what the kids were saying about me. i'd still feel bad about it and everything. >> reporter: the cost of elective surgery, however, made it an impossible solution for renata and her mom. but then they heard about another 14-year-old girl who said she was bullied because of her looks, and transformed her appearance through surgery, donated by a non-profit group called the little baby face foundation. after seeing that story on the news, renata's mom made a call. >> i spoke to a lady, i believe her name was diane. and she told me that i needed to submit an application online for renata. >> hi, my name is --

>> so renata's journey would begin with this, the story in this letter. >> i tried convincing myself that i am fine the way i am, but i just don't believe it anymore. coming up is renata making the right choice? >> are we saying the responsibility falls on the kid who's bullied toy ed toto alter themselves surgically?

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reporter: traumatized by bullies who made fun of her looks, 14-year-old renata was becoming more isolated day by day. her mother michelle says two years of home-schooling had not made her daughter any happier. >> she wants to go back to school, and i want her to go back to school. it's just that she's not going to go back until she feels better about herself. >> reporter: renata gave up hope that the bullies would ever

change. >> they'll just keep picking on kids. >> reporter: and that convinced her she had to change, through cosmetic surgery. >> if i had this operation done, it would probably change my whole life, in a good way though. >> reporter: can a scalpel change how these children are feeling? >> i think we've seen that it makes a difference. >> reporter: dr. thomas romo, a plastic surgeon, and his wife diane run the little baby face foundation, the group that renata and her mom heard about on the news. based out the romos' private practice in new york, the nonprofit treats low-income children with facial deformities. >> you take a child and you change the way they look. to anybody who sees them, they're good looking, that gives the child strength. we can't go after the bully. but we can try and empower the children. >> reporter: each year, hundreds of children apply to the foundation, and it could take several months to decide which kids the doctors will treat. "dateline" was invited to go inside the foundation to witness the process.

>> this is kind of the meat and potatoes of the foundation. this is why we volunteer. >> reporter: inspired by his overseas missions treating children with facial deformities, dr. romo wanted to do the same in the u.s. and he recruited some of the best plastic surgeons in new york to help him. >> i said, "how much fat do you want to suck, and how many boobs do you want to do?" people are going to look at you and say, "wow, you treat real patients." >> we could move this over and then close the hole. >> reporter: their work never gained much notice, until they decided to treat that bullied teenager nadia ilse. like renata, nadia said she was picked on because of her looks. nadia asked for her protruding ears to be pinned back. to her surprise, the foundation offered to the do that and more, giving her a nose job and a chin implant as well. when her make-over made the news, it sparked a wave of criticism.

>> are we saying that the responsibility falls on the kid who's bullied to alter themselves surgically? >> reporter: psychologist vivian diller says promoting elective surgery as a remedy for bullying sends a harmful message to kids. >> we really have to address the idea that there should be zero tolerance of bullying, and maybe we even have to encourage the acceptance of differences. >> reporter: there was one of the kids we talked to who said look if it stops the bullies, great, i want to do it. because if we're trying to change the bad guy, we'll be here forever." >> i suppose one way to look at this is, is there some benefit to learning how to struggle with adversity. we're not convinced that confidence is gained by changing the way you look. >> reporter: despite the criticism, applications to the foundation soared, many of them from other bullied teens. >> we could get 60 in a day. we respond to every one of them. >> reporter: but the romos say an applicant, even a bullied one, must have a facial deformity to be considered.

let's talk about the word deformities, because that scares me a little bit. when i think deformity, i think of, like, a cleft lip, something that you look at, and you say, "wow, that needs to be fixed." when you say deformity, you see something else. you see something that's out of sync. >> there's a spectrum. so some are really profound, and some are minimal, but they're still a facial birth abnormality. >> reporter: dr. romo believes plastic surgery could be helpful for some bullied children. do you feel like the bully wins? >> no. >> reporter: the bully basically bullied them into getting some kind of surgery. >> i don't think that that's reality. again, they have to have a facial birth defect. and they go back and they may be the best looking kid in the school. and they're not getting bullied anymore. now, that's just the feedback that you would get from a patient that you operated on their heart and now they're jogging again. >> reporter: doesn't it put the burden on the victim as opposed to the bully? is that sending the wrong message? >> i don't think it's sending the wrong message. she still sees what she sees in the mirror and it has an effect

on her self-esteem and confidence, regardless of what anyone says. >> reporter: what do you think about that question, renata? >> well, i think if they see you getting the surgery to fix something that they have teased you about, i think it would make them feel bad and maybe it would change their mind about doing it. >> let me take a look at her pictures and see what's going on here. >> reporter: will the romos consider renata's case a facial deformity, worthy of help? diane says they follow strict criteria. >> we only help children with facial birth defects. and then i start to look at the parents' income to make sure that they could not otherwise afford this. and then their story. >> dear dr. romo, diane and staff. i am writing this letter to you -- >> to check on the status of my file and to thank you for considering me. >> reporter: this letter was from a 16-year-old in illinois named connor. >> i don't like my face because i feel like everyone's like looking at me or like talking about me, and i get made fun of for it. >> reporter: conner was born with minor cleft lip, and the

surgery to fix it left a scar. but it's his nose, he says, that's made him an easy target. >> the teasing makes me feel very self-conscious, and which in turn makes me somewhat shy, especially around girls. i wouldn't mind dating right now. >> is there someone you like? >> uh, i guess. yeah, i would ask her out after i got my nose done. i don't know if i would ask her out like right after but -- i come from a very large family of eight and it's difficult for my parents to afford my procedures. this is my sister, paige, and my sister, jordan. yeah, i don't really look like them that much, most people would say. >> reporter: his older sisters saw connor struggle more and more. >> when he gets the all eyes on him and the attention, i feel like that's when he's like self-conscious about it. kinda just, "don't look at me." >> but he's never had a date to the dance, doesn't like to put himself out there. i don't know, i feel bad for him. >> reporter: there are people who will say, "connor, you're going to grow into your looks." have you thought about waiting

and seeing? >> i did, but then i was like, i don't really want to wait. >> reporter: connor's family members, including mom kimberly, hoped the foundation would choose him if, in fact, surgery could make connor happier. but as other bullied kids applied in droves, hoping to be selected -- >> it's basically a chin implant. >> reporter: some of their parents weren't sure if surgery was the best way to help their child. >> i hate to see him put so much emphasis on just one feature. that's not what makes a person a person. coming up one teen who thinks surgery for her bully son might be a mistake. >> how much would his life really change? >> i would love to see him discover it's not the outward appearance that would make his life complete.

reporter: is changing a face the best way to change a life? >> people would just come up to me and just be like, "why don't you have a chin? i mean, everybody should have a chin." >> reporter: the story is familiar, but no less painful for the kid living it. we met a student from wisconsin when he was 16. his name is donovan.

>> there were times where people would walk around with like their heads like cocked back or something, to make it look like they don't have a chin, to mock me. high school's hell. my chin has caused me to become more reclusive. i do have a few guy friends. they kind of are dispersed. they are my friends i think. are they my friends? >> yeah, we are. >> i don't know why people have to be so mean. >> reporter: so what was it like walking the halls? i mean do you always look over your shoulder? >> it was a war zone, yeah. >> whether it was being cornered or being tripped or just punched in the shoulder or something. >> reporter: donovan says the bullies would always deny what happened, so the school rarely took action. >> i've almost had to deactivate my facebook account because of the bullying. like, "donovan is gay.

don't talk to donovan." >> reporter: what did they say that pushed you to the edge? >> the same guy that posted on facebook, he just straight up said, "donovan, why don't you just go kill yourself tonight? it would be better for everybody." >> reporter: you've never considered anything like that. >> a few times i have, but i've never gotten so close to the edge where i wasn't able to return. >> reporter: donovan applied to little baby face, hoping the group's doctors would fix his small chin. now surgery is dramatic. why do you want to take such a dramatic step? >> i believe if it's not there, people won't talk about it. >> reporter: it would stop. >> it would just be like normal. >> reporter: really? >> i know there will be, like, backlash. like oh, he's like the one that lost. but i think i would be the one that won because i did something about it to make it stop. >> reporter: donovan's parents and brother supported his pursuit of surgery. >> a long term goal will soon be achieved. i thought it was a sign of good things to come. >> reporter: but when her son wasn't around -- >> he was all cheeks but he definitely had a chin, little protruding chin. >> reporter: donovan's mom sue told us she had mixed feelings about the surgery. >> if he did have the surgery and have this perfect chin, how much would his life really

change? and i would love to see him discover that it's really not the outward appearances all of a sudden that would make his life complete, but that he's learned to put his best chin forward. >> reporter: psychologist vivian diller agrees. and she says parents should know that cosmetic surgery not only has physical risks, but psychological ones, too. >> in my practice i do hear regrets. >> reporter: you do? >> they complain that they don't look like their family anymore. i kind of miss my face. >> reporter: dr. diller sees a better, long-term solution for all three of these teens. >> if you can find a way of enjoying how you look, you can gain the kind of confidence that will last you a lifetime. >> reporter: this young girl seemed to prove that point. she was born with a rare condition commonly called bpes that affects the appearance of her eyes. though it has taken years, she says she built the confidence to be herself. her name? cheyenne.

>> there's, like, some days where i feel i'm not pretty or i'm not normal. but other days i'm, like, "oh okay, i don't care what people think." >> reporter: standing by cheyenne's side, her mother, jamie. >> it's tough being a military family and moving so often. she goes through a lot at every new place, but she's been so strong in doing it. >> reporter: cheyenne went through several corrective surgeries, but didn't see any improvements when she looked in the mirror. you must have been over surgery for a while. "they're not working. why do we keep doing them?" >> yeah, she gave up. >> i actually gave up like a few years ago. i lost hope. >> reporter: but what she lost in hope, she gained in fortitude. and sometimes, she says, she could see herself as beautiful. >> i see prettiness sometimes, but then when i go back and i look at the picture, like "what was i thinking?" >> reporter: when you hear your daughter speak like that, i feel pretty and then sometimes i look back and say what was i thinking? >> i don't like the last part.

>> reporter: cheyenne's mom wanted her daughter to embrace who she was. but she also wondered if there was a surgeon, somewhere, who could make cheyenne's eyes look more normal. so when she heard about the foundation, she felt conflicted about applying, not sure if she should expose cheyenne again to the risks of surgery. or more disappointment if she wasn't chosen. >> you just don't want to let your child down ever. i chose not to tell cheyenne at first. >> reporter: secretly, jamie applied for her daughter. but when "dateline" asked to document their application process, she decided to talk to cheyenne about it. >> what do you think if you didn't get picked? >> i'd be sad but i would get over it. >> not everyone looks the same. >> yeah. >> but you can still have a normal life. and be beautiful, and be outgoing, and have friends. >> if you don't get picked i would feel bad because i would feel like i brought undue stress. i did open this door and that it would've been open

unnecessarily. >> reporter: renata's mother also didn't want to get her daughter's hopes up. >> you just never know. >> reporter: but she also couldn't contain her own excitement, that a call from the foundation might actually turn her daughter's life around. >> i'm very hopeful that they're going to choose you, that's all i think about. >> reporter: in the meantime, renata finally agreed to see a mental health counselor, catherine brown. she told us she was against kids using elective surgery to build self- confidence. >> my goal is to help her see herself as being beautiful. and i hope that she won't want the cosmetic surgery anymore, but that's still i guess her choice and her decision. what kind of negative things would you be thinking? >> i guess that i'm just nothing. >> so is that the reason you're staying in the house so much? >> yeah, that's a big reason why. >> reporter: renata's mom hoped therapy would help this time, since there was no guarantee

renata would be picked for surgery. in fact, while all these teens waited for a decision, some would take the brave step to solve their problems on their own. coming up, connor decides to confront these fears and friends head on. >> does it make you feel bad?

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reporter: several months passed while these four bullied teens waited to hear back from a plastic surgery foundation that might just change their lives by changing their looks. but just being bullied won't get them chosen. >> we are not a bullying foundation, but we have kids with facial birth defects that are bullied. she's 14 years old from alabama. >> reporter: cheyenne was born with the condition bpes.

here, the foundation's doctors debated if they could improve upon the surgeries she's had before. if they decide they couldn't help her, she wouldn't be coming to new york. >> she's had considerable work done. this is very very hard to fix. >> reporter: but it was still unclear if renata and connor's noses, and donovan's chin, qualified them for the foundation's help. >> let me see his picture. there's a fine line here with helping somebody with cosmetic surgery or a facial birth defect. >> reporter: as the foundation considered that question, we found donovan sitting alone in his room on prom night. >> prom is going on, and i'm here. i do not care. i've heard it be called a rite of passage for some people, to some it's just another night. >> reporter: connor, too, had never been to a high school dance with a girl. >> they wouldn't like the way i look or like how large my nose is. >> reporter: but it wasn't just his insecurities around girls that made him want surgery. connor's own buddies were part of the problem.

>> they all make fun of each other, but -- >> reporter: right. but you feel like you get the lion's share. >> yeah. >> reporter: though he still wanted surgery, connor bravely decided to tackle his problems head-on, by letting his friends know how much the teasing affected him. >> does it, like, bother you when people talk about your nose or no? >> well kind of, because like some people, i think they're talking about me. >> what name do you think gets to you the most? >> i don't know. there's a few. the one that you guys made up was toucan. >> who was that, mike? >> do you like kind of take it as a joke? because we really don't mean to offend. >> well from you guys, like i'm kind of alright with it. but then like there's other people i'm not friends with who say it. >> how long have you been like getting picked on for? has it been like since you were a little kid or -- >> like 7th or 8th grade kind of. >> geez. >> wow, that's bad. >> reporter: it was the first time connor had ever opened up to his friends this way. >> i feel bad when i make fun of connor because it's like something he can't help. i don't know if he takes it seriously or not. i never really asked him.

>> does it make you feel bad? >> when we call you toucan and all that. >> a little. >> anything you want to say to us? >> not really. >> you want us to stop? >> reporter: they asked you, "does it bother you?" >> yeah. >> reporter: and what did you feel like when they asked you that question? >> it was weird because, like, they never asked me anything like that before, you know. >> reporter: would you feel better if they didn't call you the names they call you? >> yeah, i'd feel a little better, i guess. >> after you opened to us like this, we'll take it easy on you. >> reporter: could this breakthrough with his friends give connor the confidence he'd been looking for, all without surgery? as she waited for the foundation's call, cheyenne opened up about her insecurities as well, here with her best friend savannah. but savannah was expressing doubts about the surgery. >> do you feel like you need to do it? >> the surgery?

>> yeah. >> no. >> you don't feel like you need to but you want to? >> yeah. >> why though? >> i don't want to be different. >> you don't want to be different? >> i do but i don't. >> reporter: then, cheyenne asked a question, one that suddenly revealed the heart of the matter. >> how does it feel being beautiful? >> why you asking me that? >> just answer it. >> but i'm not that pretty. >> yes, you are. >> no, i'm not. >> yes, you are! >> no, i'm not. >> seriously? >> you seriously want me to answer that? >> yes. >> it's not great. >> why? >> you still, like, people find every reason to hate on you. >> reporter: it was the first time cheyenne heard this perspective from a friend, that looks don't always equal happiness. bullies are irrational. they don't just pick on the funny looking kid. they pick on the kid they feel like is weak. and i don't know if that makes you strong because you have your nose fixed.

i think you may still sometimes be that same insecure kid still. >> part of that dynamic of a bullying and the child being bullied is also the acquiescence of the child that's being bullied. if you self-empower that child and they don't look at themselves that way, the loss of self esteem. the anxiety, the depression, the suicidal tendencies. if you can roll that back, then the bullets that are coming in from the bully may not have that same effect on that child. >> reporter: while dr. romo believes that plastic surgery may not be for every child, he cautions against judging parents who feel this is the right solution. >> don't be pc, and say that somebody else's child shouldn't have the option of doing that. >> reporter: while renata waited for a decision, she continued to go to mental health counseling. but the counselor, who was against renata having surgery, didn't see any progress. in fact, she saw a girl so walled up in her self-isolation that it was the counselor who had changed her mind about surgery. >> knowing renata, i do think that it would help her to feel better about herself.

much, much sooner than, than just having counseling. she's making herself antisocial. i'm closing the door behind me. i'm at home. i don't want to be a part of that anymore. so that's why i would say her situation is more extreme than other situations. >> reporter: will the people in new york evaluating renata's case agree? >> hello? >> hello, renata? coming up who will be chosen for possibly life-altering surgery? >> oh my god. >> and who won't?

reporter: the foundation that treats children with facial deformities finished evaluating these four cases. >> hello? >> hello, renata? >> yeah? >> my name is diane, and i'm with the little baby face foundation. >> reporter: renata had been waiting anxiously for months, thinking a straighter, smaller

nose would silence her bullies and improve her self-confidence. >> i am looking at your beautiful picture that you sent us, and i just read the beautiful letter that you wrote. i want to invite you to come to new york to see if we could help you. >> are you serious? >> very serious. >> oh, my god. thank you so much. you made me so happy. >> i'm glad you're happy. i can see you smiling right through the phone. >> that was great! >> that was great. it feels great. >> she's going to come out great, too. >> i am so happy, oh my gosh! >> i can't believe we're going. >> i can't believe we got chosen. that is awesome. >> reporter: next, conner. his friends promised to stop making fun of his nose, but will the foundation offer to fix it? >> i have a doctor who's going to work on your cleft lip. and i have another doctor, thomas romo, who's going to do your nose. >> thank you. >> you are welcome. all right, let me talk to your

mom so i can explain all this. >> children that are born with cleft lips, they also have a cleft lip nose deformity and they look like conner. so conner's nose, it wasn't just so much it was big, but his septum was totally obstructing his left airway. and the arch of his nose was totally under supported. >> what are you thinking about? >> new york really, and how i'll look after surgery and everything. >> i was wondering what he was thinking because he wasn't saying much. but i'm sure he was pretty happy. >> congrats, con. i'm happy for you. >> reporter: then, donovan's turn. he asked the foundation for a more prominent chin, but mom thinks he should keep his head up instead. >> how are you? >> pretty good, pretty good. >> i know that you were bullied because of your chin. but i want to tell you something. when i look at this application i see this handsome, 16-year-old guy. and from the pictures that you sent me it really just looks like you just need a very minor cosmetic procedure and it really doesn't fall under our mission

statement for the baby face foundation. >> it's a pretty big disappointment. i guess i can live with it. >> reporter: what was it about him that made you not select him? >> i really felt that his case was cosmetic. and that other children with more severe cases than his. >> reporter: donovan's mom hopes her son will bounce back. >> you have to do a lot of inner soul searching to find that part of you that gives you strength. >> reporter: and finally, cheyenne. >> cheyenne? >> reporter: she's tried to correct her eyes through surgeries before. though she's learned to accept the way she looks, her mom decided to give it one more try. >> this is a difficult case. i'm still looking at that beautiful face but i'm just trying to figure out how our doctors can take care of you. >> reporter: diane told cheyenne her eyes would not be easy to fix. but she also told her to pack her bags. >> yes! >> i just explained to her we've been trying to figure out what we could do to help. that the only way that we'll know is to invite you to new york for a couple of days

and then make a plan. >> okay. >> reporter: opening a closed door can sometimes be overwhelming. >> that would be wonderful. >> reporter: don't cry because if you cry i cry. if i cry my mascara goes. forget it, we're done. >> okay. thank you so much. >> this is the best part of my job making this phone call. >> reporter: how do you feel when your mom gets emotional about stuff? >> don't like it. >> reporter: you don't? how come? >> 'cause, i mean, there's no reason. >> reporter: welcome to new york. renata went directly to her pre-surgery appointment with dr. romo. >> and what we're going to do, is we're going to straighten that septum out, and we're going to take this little thing down and make this whole thing

smaller. okay? >> thank you so much. >> renata, actually, once you pinned her hair back, had a diagnosis, what's called a hemifacial microsomia. >> reporter: and what is that? >> half the face is smaller than the other side of her face. and that's why this nose is leaning to the left. >> reporter: is that an unusual thing? >> it's actually not that unusual. it just doesn't get treated that often. we make a little poke hole here. >> reporter: then, he unveiled his treatment plan. >> so it'll balance her face. >> reporter: and it involved more than just a nose job. he offered renata a new chin as well. >> it's just something i've been thinking about, that we were thinking, something we want to do. >> reporter: wow. we're pointing out something else that she didn't even -- she wasn't even worried about. >> when someone comes in to me about a nose problem, i pin their hair up because i want to look at the whole face. the nose, the eyes, the lips, the jawbone, all have an interrelation. >> do you want to do the thing what he's talking about, the chin? do you understand what he was talking about? >> yeah, i understood. >> what do you think about it? >> it's a big decision.

>> it's a huge decision. >> i don't know what would be better. >> you don't have to. if you don't want to change anything else you don't have to. >> reporter: if you looked at me, and you were to say to me, "hoda, that chin." and i might say, "i think i'm fine with my chin." i promise you, dr. romo, every time i look in the mirror for the next five years, i'd be looking at my chin. because a doctor says there's an issue with it. she's a vulnerable kid, she's going to do whatever you say, period. >> it's the doctor's responsibility to point those out. i know when they're going to have a more successful result. >> reporter: cheyenne spent a full day seeing specialists. at the end of it, dr. romo reported what sounded like disappointing news. >> your eyes, your brows, and your eyelids, could physically be brought up higher. >> yup. >> the problem is you wouldn't be able to close them. >> we couldn't make her eyes actually larger. we couldn't pull her eyelids too tight because she had to close them. >> reporter: but dr. romo still saw a surgical solution. instead of operating on

cheyenne's eyes, dr. romo recommended a nose job and pinning her ears. >> one of the ways to make the eyes look bigger is to make the nose small and deflect the look of where the ears are. and just setting this back so this is less obvious. >> reporter: it seems like it's additional surgery and work that will change, you know, the way your daughter looks. >> first of all, i'm concerned about any surgery. i leave the ultimate decision up to cheyenne because it's her body. >> reporter: what do you feel? >> i know i'm beautiful. but you know, some things you got to change to make yourself even more happy. >> reporter: during connor's evaluation, dr. romo also recommended a new chin to go with a new nose. connor and his mom agreed. >> see how the chin, bringing that out just a bit, it opens the face up. >> reporter: renata decided to take dr. romo's advice, too. >> well, i've decided that i'm going to get the nose and the

chin done. >> i thought i'd just trust him because he knows what he's doing. >> i can't believe we made it here. >> i didn't think we'd come this far. >> this is a big moment. >> i'll see you in a few hours. >> i love you, mom. >> i love you so much. good bye. i love you. good bye, baby. >> reporter: as they headed into surgery, all three imagined sweet dreams. >> surgeon: sweet dreams, cheyenne. >> reporter: not for when they close their eyes, but for when they open them. coming up, the bandages come off. how life has changed for the three who had the surgery and the one who didn't.

time of operation is two hours and 36 minutes.

>> reporter: can the confidence and self-esteem of children be lifted the way a face can? dr. romo says he's not trying to give these kids complete makeovers, but believes small surgical corrections make a big difference. >> the changes are subtle in the eye of the beholder. the children don't consider them so subtle. >> reporter: when we first met renata, she was so self-conscious about her looks that she rarely left her house. >> i don't go to regular school because a lot of the kids just make fun of me, how i look. >> reporter: now she was about to see her new nose and chin without bandages. >> wow. >> isn't that great? >> yeah. >> now it's swollen. it's going to go down. >> you look gorgeous. >> so straight. >> you look gorgeous, renata. >> i really love it. >> it could not be more perfect. >> what a beautiful woman. >> it just looks really amazing.

and i can see the bump is gone and it just looks perfect to me. >> she has not been this happy in years and i just couldn't wish for a better result. parents correct children's teeth with braces to make their teeth straighter. they're still the same kid on the inside but unfortunately people are judged on how they look. and i think that's what happened to my daughter. >> reporter: when we visited renata a few months after her surgery, things had changed dramatically. >> i've been going off the computer a lot more and i've been going out a lot more. >> renata is much more, you know willing to talk to people that she sees and she's just happier in general. >> yes, my daughter's here to see the guidance counselor. >> new enrollment? >> yeah. >> reporter: after nearly three years of home-schooling, renata went back to the classroom, enrolling in her local high

school. >> a lot of people say that high school is the best time of your life, so i wanted to experience that too. >> oh awesome. so you're excited. >> reporter: now in her sophomore year, she's also making new friends. >> i feel happy and i feel confident. and i feel like i don't have to hide myself anymore. >> reporter: and now, connor. he wanted a smaller nose, hoping it would make him less self-conscious around girls. >> think like it affects how i talk with girls because i feel like they'd wouldn't like me because my nose or my appearance. >> reporter: so, he changed his appearance with a new nose and a chin implant. >> it's been about two months since i had surgery and i'm doing really good. no one really said there was a huge difference. they said i look a little different. >> reporter: but connor says he definitely felt different after the surgery. and he saw a difference among his friends, too. though that started happening even before he left for new york. >> yeah, they have stopped giving me a hard time. probably said a couple things, but not like as much as they did before.

>> reporter: and then, something he once thought would never happen. he went to his first school dance with his first real date. cheyenne's case was the most complicated. her eyelids couldn't be pulled any higher. so, the doctors made her nose smaller and pinned back her ears -- all part of the illusion, they hoped, to make her eyes appear larger. >> i love my nose. it was a potato nose as dr. romo called it. this dress is my prom dress. i like the color of it, the style. yeah, i like how my sister did my makeup. the change that i see right now is kind of what i imagined, like i imagined my eyes a little bit wider. but i like it the way it is. >> reporter: the friend most eager to see cheyenne again was savannah. she never thought cheyenne needed surgery, but she liked the results. >> she does look different, but not all that much. which is what i was worried

about in the first place. she was beautiful the way she was, and she still is and the only thing that came out of her going to new york was me missing her. >> reporter: cheyenne says she is, finally, at peace. >> i think i'm done because i like the way i look now. you know if anyone has a problem, i don't care. >> it's going to help them go to college. it's going to help them get a job. it's going to help them be social when they otherwise wouldn't. the bully's going to be left in the dirt. >> reporter: and donovan? he was disappointed when he wasn't chosen. but just a few months after his letdown, he told us he'll had a -- he'd had a profound change, too. he says not being picked for surgery turned out to be a blessing. >> i'm feeling good about it now. i don't have to have surgery after all. and it's just -- it's kind of a weight off my shoulders. >> reporter: in fact, he says, keeping his weaker chin gave him a stronger voice. at school, he started a campaign to raise awareness about

bullying, passing out wrist bands and collecting donations for a local anti-bullying charity. he's already felt the impact on a personal level. >> a lot of people have really opened up to me and apologized for the years. >> reporter: and since then, he's been on a few dates, and even joined his first rock band. >> i learned that there is actually -- there are people who care for me and like me for who i am. >> reporter: mom sue says she couldn't be more proud of her son and his change of heart. >> he's grown stronger, more confident. and i think that's what's going to take him through this world and make him the person, the best person he can be. >> reporter: all the teens we met are happy with the paths they took, though it may take years before they know the lasting effect of having surgery or not. but if there's one thing they can count on today, their teen years, with all that pressure and anguish, won't last forever.

that's all for now. i'm lester holt. thanks for joining us. blah this sunday, terror in denmark. two victims it dead and the alleged shooter. >> we feel certain it is a previously motivated attack and therefore it is a terrorist attack. >> one target, a swedish cartoonist on al qaeda's hit list. he survives. but a man shot debt outside a synagogue. we'll have all the latest. and fixing the va. what the agency's new leader has done. >> 900 people have been fired since i've been secretary. >> and what's still ahead, making sure veterans have the care they deserve. plus one year out, we have brand-new numbers in the race for 2016 from first three states that will start the voting. and 40 years of