Facial surgery result amazes patients

By: New Zealand Association of Plastic  05-Apr-2012


A Christchurch teenager has her looks and facial movement back after a tumour was removed and replaced with tissue from her stomach and a nerve from her leg.

Nineteen-year-old Toni Gilmore learnt she had a malignant tumour in her face when she was 16.

She had her parotid gland - the largest of the salivary glands - removed, along with the facial nerve that branches out and controls movement across the face.

The cancerous tissue was replaced using soft tissue from her stomach that was "replumbed" into her face.

In complex microsurgery, plastic surgeon Barnaby Nye used a nerve in the back of Gilmore's leg to replace the section that was removed and graft it to her eye, cheek and lip muscles to give her a normal look and movement.

No skin had to be replaced, allowing Nye to redrape her skin over her face and sew it up behind her ear.

Gilmore said she spent about a year with the right half of her face paralysed as the nerves grew and started to function again. When she was told what surgery would involve, she was shocked.

"I was just amazed at what they could do. Everyone thought I would have a breakdown, but I was fine. I thought, `There's no point breaking down about it'."

Nye said microsurgery did not get more technically challenging than reconnecting nerves and blood vessels in a person's face.

The operations involved a multidisciplinary team of surgeons and usually took between 14 and 16 hours.

Jaw rebuilt after cancer

Suzanne Smith showed her workmates her new chin and was told "you look younger".

It was another positive step for the Christchurch woman after a facial reconstruction using bone from her lower leg and skin from her thigh to create a new jaw and chin.

"It's absolutely unbelievable what they have done," Smith, 62, said yesterday.

Four surgeons worked for more than 12 hours last month to remove Smith's bottom lip and chin and most of her lower jaw after a cancerous tumour developed.

At the same time, surgeons took part of her fibula bone and broke it into three pieces to shape a jaw. A titanium plate was used to screw the bone into place, with the artery and vein plugged in at the side of her neck.

Christchurch plastic surgeon Barnaby Nye said he needed to use live bone because dead bone would die with radiotherapy treatment.

A large flap of soft tissue and skin was dissected from Smith's thigh to cover the new chin, and blood vessels were reattached to the other side of her neck.

A lower lip has since been shaped, and Smith is able to eat pureed food until she gets a new set of teeth in six months.

Smith said that when she was first told about the operation she was "a bit taken aback".

"But when you are told you have a cancerous tumour there, you basically think to yourself, 'Just do anything; just take it away'," she said.

Smith, a credit controller at a glass company, visited her workmates yesterday for the first time since the operation, and "their first remark was that I look younger".

"Maybe they pulled my cheeks in a bit when they did the operation," she joked.

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