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Building a Nose for Holly

Building a Nose for Holly staff report

Consumer Brief: Holly Buck suffered from a disease that eventually ate away her nose, leaving only a void in the middle of her face. She entered a radio contest, won and had the first of a handful of reconstructive surgeries from gifted and caring plastic surgeons who have so far donated about $100,000 of cosmetic surgery to Holly’s reconstruction.

It seemed like life was not treating 35-year-old Holly Buck very well. In fact, you could almost say life was beating her down.

First, her husband, 23 years her senior, died due to heart disease and left nothing behind for her and her stepson. Since the mid 90’s, Holly suffered from Wegener’s Disease, an ailment that attacks the body’s joints. But by 2004, Holly had also lost her nose, leaving only a cavity covered by a little skin in the middle of her face. That condition lead to severe breathing problems and lost senses of taste and smell.

“Losing my sense of smell and taste was punishing,” Holly says. “My family has always enjoyed gourmet food tremendously because my dad’s hobby is going to great restaurants, and then later duplicating the world-class dishes.”

Around 2001, Holly had surgery to clean out the nasal cavity but the surgeons shied away from reconstruction. Still later, Holly consulted another plastic surgeon who said nothing could be done about the missing nose. But worst of all, Holly became a virtual recluse in her parent’s home although she continued at her bookkeeping job at a local car dealership where she had minimal contact with the public. She occasionally ventured out at night with a scarf covering her face.

“Little children would point and laugh,” Holly recalled. “People asked me if I had been in an accident and my dad broke down in tears when he first saw me for the first time after my nose had collapsed.”

Building a Nose for Holly At the dealership, Holly heard about a Denver radio contest, “Nip, Tuck Head to Toe” that would award $5000 worth of plastic surgery to the person who wrote the most convincing letter explaining why they should have the surgery. The letters were posted on the radio station’s website and the public asked to vote on the most convincing. Holly won, hands down, with 70 percent of the tally and was sent to the Longmont Clinic for a medical evaluation by plastic surgeon Raj TerKonda, MD, who specializes in facial plastic and reconstructive surgery.

“The disease had destroyed all the cartilage in Holly’s nose,” Dr. TerKonda told CosmeticSurgery.Com News. “Of course, the radio station knew nothing about her underlying medical conditions. But it was clear to me from the start Holly needed far, far more than a simple $5000 nose job.”

The nose is probably the most difficult thing on which a plastic surgeon works because the human nose is a three-dimension structure. Not incidentally, the nose is also the feature most in need of revision surgery by top plastic surgeons after less experienced physicians have bungled the job. A rhinoplasty is also a very delicate undertaking -- tiny slivers of bone added or removed can make a tremendous difference in the size and shape of a surgically enhanced nose.

The first operation required ten-hours. John Campana, M.D. a surgeon from University Hospital in Denver pitched in and volunteered his special skills with bone reconstruction on Holly’s case. The surgeons shaved bone shards from the top of Holly’s skull where it is thickest to build the scaffolding of the nose over which skin would later be draped. The surgeons used the skull shards and surgical mesh to create the basic structure of a nose using surgical screws and other hardware that was specially designed and donated by a surgical products company.

Building a Nose for Holly “Building Holly’s nose was like making something from an erector set,” Dr. TerKonda says. To cover her new nose with skin, the surgeons cut a flap of skin from her upper forehead and scalp and pulled it down over the bone-and-mesh nasal edifice they had just created. That flap was left in place for two months until it developed its own blood supply. Then, it was cut away and stitched into place. (Her scalp was pulled down to cover what was taken from her forehead and stitched it into place.)

Says Bill Buck, Holly’s father: “I’ve known a few artists in my time and I think Dr. TerKonda is as much artist as he is a doctor.”

“I never thought I would have a nose again,” Holly says, eight months after the operation. “And I couldn’t be more pleased to have my sense of taste and smell back again. I still have some scarring on my face but that is fading as time goes on. I’m able to cover 90 percent of the scaring with a special medical makeup.”

Another dream of Holly’s back within reach is chef and cooking school. With her sense of taste back, and a long history of sampling world class recipes, Holly is determined to become a chef. Currently, she’s out – in broad daylight -- looking for a job, going through the rigors of interview with more self confidence than she’s known in many years. Moreover, most people don’t notice anything at all about her appearance.

“Holly has gone from being nowhere near normal to having at excellent chance at being completely normal and more fully rejoining society,” Dr. TerKonda says. “She is far happier than before, she breathes much better now and the whole issue of disfigurement is gone.”

Two more, shorter procedures are needed, says Dr. TerKonda, to remove scar tissue and perhaps doing some cosmetic dentistry.

Holly says she wants the dental work because she’s smiling much wider these days.

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