Dateline | January 06, 2014
>>> entire operation at 2 hours and 30 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 for the first time.
>> isn't that great?
>> now, it's swollen. it's going to go down.
>> you look gorgeous. 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. it just looks perfect to me.
>> why don't you guys get out of here, all right?
>> all right.
>> she has not been this happy in years. 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. my daughter's here to see the guidance counselor.
>> reporter: after nearly three years of home schooling, renata will finally return to a classroom this month.
>> you know, a lot of people say that high school is the best time of your life . so i want to experience that, too.
>> oh, awesome. so you're excited.
>> 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.
>> i think, like, it affects how i talk with girls because i feel like they wouldn't like me because of 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 feels like it's a huge difference, that 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.
>> they have stopped giving me a hard time . probably said a couple things, not, like, as much as they did before.
>> reporter: he says he may finally ask a girl out.
>> the chances of asking someone this year than last year probably higher because i'm not that shy anymore or anything.
>> reporter: cheyenne 's case was the most complicated. her eyelids couldn't be pulled any higher. so doctors made her nose smaller and pinned back her ears, all part of the illusion, they hoped, to make her eyes appear larg larger.
>> i love my nose. it was a potato nose, dr. romo called it.
>> this is my prom dress. i like the color of it. the change that i see right now is kind of what i imagined. i imagined my eyes a little 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. we paid him a visit five months later, and he told us he had a profound change, too. he now 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 the surgery, after all, and 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 wristbands 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 all the years.
>> reporter: he dated a girl for several weeks and took her to his homecoming dance.
>> i learned that there are actually people out there that 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 .
>> oh, boy.
>> he's grown stronger, more confident, and i think that's what is going to take him through this world and make him the person -- the best person that 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 will not last forever.
>> reporter: that's all for this edition of "dateline." we'll be back again friday at 8:00/7:00 central. i'm lester holt . for all of us at nbc news,