Last trip on Aug 1, 2015,  I encountered an incredible case. A poor little girl with a horrific tumor of the face. I do not know why it was not treated earlier. She came on the last day of the trip and I decided to just examiner her under anesthesia in order to plan to do the surgery the following trip, September 17, 2015. We gave her a small does of Ketamine and after examining her,  I immediately realized the surgery was possible-so we did it!.

Eric our nurse anesthetist (probably the best in the world), cautiously intubated her and the surgery began. Then miraculously, it was over. I must have been in in a trance or the "zone" because I do not remember doing the surgery. It went very well. 

I have consulted with several specialists in nasal reconstruction. As you can see, she has many problems in order to reconstruct her face-missing nasal skin, missing cheek skin, open maxilla with loss of bulk and cheek support and missing upper lip. reconstruction is possible but will tax my skills. We will let her heal and improve her nutrition before we do more surgery. the pathology is pending.

One week following surgery