A 17-year-old from Ireland, who has a rare disease that left him without a jaw or chin, underwent several hours of surgery Monday with the hope of someday having a "normal" face to show the world.
Alan Doherty, who has an almost unheard of condition called otofacial syndrome, underwent the first of what will be several surgeries over the next year at The Mount Sinai Medical Center.
Surgeons took Doherty’s hipbone and transferred it to his back, where it will be housed under the skin for several months.
The procedure will allow the bone to receive nourishment and surround itself with nerves until it is ready to be transplanted to Doherty’s lower face. In October, microsurgery will be performed and surgeons will use the hipbone to build a jaw and a chin for Doherty.
Doctors also readies Doherty’s face for reconstruction and widened his mouth to ready it for dental work.
Doherty traveled with his parents to New York from his home in Letterkenny, Donegal in Ireland this week for the surgery, which will cost hundreds of thousands of dollars to perform.
It is being paid for through donations that have been raised by Doherty himself (who went door-to-door in Ireland asking people to help him get a new face) and The Physically Challenged Irish and American Youth Team Inc., chaired by New York attorney William Broderick, which brought the teen to the United States and arranged for his treatment.
“I met him last summer,” said Broderick. “He came over with a team that we brought from Ireland to play in the New York State physically challenged games.”
Doherty and Broderick first met in a refreshment tent at the games. Broderick asked Doherty if he wanted something like a drink or maybe something to eat.
“He said, ‘Mr. Broderick, can you get me a new face?’” Broderick recalled. “I wasn’t expecting that response. But how could I not help him? I said I’ll take you somewhere tomorrow and maybe I can get you a new face.”
The Team of Doctors
Broderick took Doherty to the Park Avenue practice of plastic and reconstructive surgeon, Dr. Elliott Rose. Rose was immediately smitten with Doherty.
“He’s so bright, so inquisitive,” said Rose. “I thought here’s a child that is so developed intellectually and yet, the lower half of his face didn’t catch up with his mind.”
Using CT scans and 3-D imaging, Rose showed Doherty what his face would look like if it were to be rebuilt. Doherty decided to go for it.
A Typical Teen
Like many teenage males, the blond-haired, blue-eyed, bespectacled Doherty loves to play sports. He plays soccer, swims, curls and even throws the occasional shot put.
But Doherty can’t do many things others take for granted. He can’t swallow or breathe on his own and doesn’t have the ability to speak. Instead, he let’s a portable computer do the talking for him. He’s also never tasted a meal, has a tracheotomy to help him breathe and a tube to help him swallow. And Doherty’s mouth opens only to the size of a quarter, which makes him unable to brush or care for his teeth.
Doherty’s father, Daniel Doherty, described his son as precocious and playful.
“He gave us a lot of trouble,” said Daniel Doherty, speaking from Rose’s office Thursday. “He’s a busy body at times. But he’s very good. Amusing.”
Alan Doherty also is a little bit of ham. Also speaking at Rose’s office, Doherty smiles and laughs often. And with a playful grin, he told a group of strangers that he knows a couple of jokes, but none that he could tell in front of his parents.
He said he hopes to get just one thing out of his surgery.
“No one staring at me anymore,” he said with the help of his talking computer. I’ve “had enough of that.”
An Experimental Surgery
Rose will lead a team of surgeons at Mount Sinai, including Dr. Alex Greenberg, Dr. Peter Taub and Dr. Jess Ting that will work to reconstruct and rebuild Doherty’s face.
“This is a rare procedure,” said Rose. “It’s only been done a handful of times. But the approach we’re taking is unique in that it’s both a high-tech and multi-specialty approach. I’m a plastic and reconstructive surgeon. We have Dr. Taub, who is a facial surgeon, and Dr. Greenberg is an oral surgeon.”
The surgeries are expected to make Doherty more “normal” looking, according to Rose. But even with his new jaw line, he may never be able to eat or speak.
“We just don’t know until we get in there how much muscle activity is available,” Rose said. “We don’t know if he’ll be able to use his tongue. Our primary goal is to achieve balance and symmetry and to make the face appear more normal. Anything else that we’re able to achieve is a bonus.”
Although he’s in for a lot of pain and numerous surgeries (two major surgeries and several smaller, refinement surgeries), Rose said he doesn’t expect any major complications to arise.
“Unlike a facial transplant, there’s no need for immunosuppression so we’ll avoid the problems that come from that,” he said. “And we’re using his actual bone so there’s no artificial exposure, which can cause infections.”
As for Doherty, who has a younger brother and sister back home, he’s not worried.
“Nothing to worry about,” added Daniel Doherty. “We’re in fairly capable hands in America.”