Wednesday, August 18, 2010

Silicone, Magnets and Clips. Oh my.

Chrissy Steltz, then and now (ABC)

Acquired facial deformity, whether by disease, violence or other calamity, whether attended by evil or not, challenges survivors to face the rest of their lives without a profile of any kind, quite literally for some. Here are two who, for their courage and sorely tried patience, have been rewarded with a brand new face.
If Bibi Aisha's surgical team at The Grossman Burn Foundation opts for a prosthetic solution, her facial reconstruction could follow a course like that of these survivors, showcased by television news magazines this summer

Listening to Chrissy Steltz tell her story on ABC's 20/20, it is hard to realize that she is also completely blind—her entire midface, including her beautiful eyes, blown away by an errant shotgun blast, over a decade ago. Said maxillofacial surgeon Dr. Eric Dierks of Head & Neck Surgical Associates in Portland, OR,"It's unique to have an injury of this magnitude to the middle part of the face that removes the vision of both eyes [and]the nose, yet allows the injury to the base of the brain to heal."
Chrissy and son Geoffery     (ABC)
In the years since those deadly teenage shenanigans, Steltz has grown up and found her way with intrepid spirit, even as medical technology has advanced to a degree that offers her a real solution for facing the outside world. Using "autografts" of bone and skin from elsewhere in her body, augmented with dozens of screws and metal plates, Steltz's doctors prepared her decimated midface to receive a kind of snap-on-snap-off mask made by maxillofacial prosthedontists Dr. Larry Over, of Oregon, and Dr. David Trainer, of Florida.
"To be looked at as a plain Jane," said Steltz, was exactly what she wanted—to be "treated just like everyone else." And to give her new baby boy a mother's face to gaze into. As Steltz told CBS 60 Minutes, "This is going to be the end of one chapter, and the beginning of a whole new one."

Donnie and Sharon Fritts    (
Meanwhile, on NBC's Today Show, Donnie Fritts, of Georgia, sat beside his indefatigable wife Sharon, looking exactly like an unremarkable middle aged man—and that is remarkable. Mr. Fritts has lost two thirds of his facial features to ameloblastic carcinoma, an aggressive cancer of the facial bones and connective tissues, so rare that of only sixteen known cases in the world, Mr. Fritts is the only person to have survived.
For Fritts, maxillofacial prosthdontist Michael Singer of the Besthesda Temporomandibular Joint And Facial Pain Treatment Center led a pick-up team of facial reconstruction specialists in creating a facial field of bone and tissue, titanium implants, gold subframe, and maxillary prosthesis which would be capable of supporting a mask of silicone, magnets and clips. That final component, the mask fashioned by former Senior CIA Disguise Specialist Robert R. Barron, would become Fritts' ticket to rejoin the full society of family and friends.

Such medical "miracles" are staggeringly expensive, partly because they are the combined efforts of multidisciplinary teams of prodigious talents, cooperating on the frontiers of medical technology, in the service of a special patient—another human being. But these two cases are only the most recent and famous cases among many performed in the United Staes. Often, the required hours, services and supplies are donated.

And in cases that succeed, the physicians always credit the steadfastness of the patients, without whose active perseverance, dedication, and constant, deliberate rededication to the project—and its outcome—everything comes to nought.
Click here for Dr. Singer's exceptionally clear and thorough description of these reconstructive procedures. Click here to watch Dr Trainer at work.

Thursday, August 12, 2010

The Face of an Afghan Miracle

Bibi Aisha has arrived in the United States for reconstructive facial surgery, reported the LA Times this week. The face of the Afghan teenager, barbarically mutilated by Talib relatives, has already become iconic, especially in the clamorous aftermath of the August 9, 2010, issue of TIME Magazine which dared to display Aisha's haunting features on its cover without apology.

Vigorous debate continues on the political and ethical imputation, the wisdom or cynical opportunism of such an editorial choice—does her image rivet the gaze or repel us—and surely this debate is one of the services rendered by managing editor Richard Stengel.

First reported in the Daily Beast by Gayle Tzemach Lemmon, deputy director of the Women and Foreign Policy Program at the Council on Foreign Relations, Aisha's harrowing saga began to rise to the surface of global consciousness only when it intersected with a U.S. military-run hospital, whose staff helped the young woman find safe haven at a shelter run by the NGO Women for Afghan Women, based in New York and Kabul.

Aisha will now be shepherded through facial surgeries and recovery by the combined resources of California's Grossman Burn Foundation and its Afghan Reconstructive Surgery and Burn Center Project. Co-director Dr. Peter H. Grossman told the Los Angeles Times that Aisha‘s treatment could include “a prosthetic nose, or reconstruction of her nose and ears using bone, tissue and cartilage from the rest of her [own] body...” And from there, on to a new life, of what shape she can not imagine. The surgeon's skill, the physician's art, the medical technology, all really do exist to make this excoriated young woman whole. In the absence of evil, miracles abound, even for such as Aisha.

Now, thanks to the near universal visibility of TIME, Inc., Aisha's face is likely not just to become a graphic representation of the plight of Afghan women, but also to be co-opted for purposes from the worthy to the ignoble. That may be as she herself now wishes, reports Lemmon. “When I meet the doctor I will tell him all of my story,” she says. “My father told me not to tell anyone the full truth... not to tell anyone anything. But I will tell them all these things because I am not such a person to lie; I will tell them because I think my story must be told.”


The wider moral, political or humanitarian aspects of this story demand informed, thoughtful and compassionate consideration. But for the moment, speaking entirely from my own experience, I will say this about the prospect of Aisha's facial reconstruction:

It is miraculous. It can be done. And for them that dare, it's always right to strive toward the unlikely miracle.

*Photograph by Jodi Bieber / INSTITUTE for TIME/ August 9, 2010