AMS Spring 2023

Little Girl Born Without a Nose Has One Built for Her Thanks to 3D Printing

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3D printed prostheses have been coming to the aid of many children over the past couple of years. This can clearly be seen in the hundreds of 3D printed hands and arms which have changed the lives of children and adults around the world. As technology improves, 3D printing is also coming to the aid of individuals who are missing other body parts, making what was once impossible, suddenly possible.

tessa6One cute little two-year-old girl, named Tessa Evans, was born without a nose, and her parents Grainne and Nathan decided to do something about it now, rather than wait until she’s older. If they had waited, Tessa’s surgery not only would have been much more complicated and aggressive, but Tessa would have also had to have gone through her entire childhood and adolescence without being able to function entirely like a normal person. Tessa’s nose can not smell, nor does it have any sinuses, although she can still sneeze and even catch a cold. The disorder, referred to as arhinia, is extremely rare, so much so that there have only been 47 cases reported in medical history. It wasn’t until Tessa’s mother had her 20-week ultrasound that it was discovered that Tessa would be born with a missing nose.

At this time, her parents were prepared for the worse, hoping and praying that Tessa’s birth would go OK.

“Doctors were able to stabilize her so she could breathe on her own and eventually I was allowed to hold her for a few seconds,” Grainne Evans explained. “I kissed her forehead and told her I loved her before they took her away. I felt so lonely and helpless, I was supposed to protect my baby and be able to help but I couldn’t. There were tubes coming out of her tiny little body everywhere. She spent her first five weeks in a neonatal intensive care unit which were undoubtedly the worst weeks of my life.”

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Tessa, from Maghera, Ireland, made headlines last year as her story went viral across the internet. Since that time though, her parents have gone forth with allowing doctors to perform a groundbreaking series of surgeries, which will continue throughout her youth, and into her teens. The initial surgery was performed with the help of 3D printing, as surgeons at Great Ormond Street Hospital in London took a CT scan of Tessa’s head and then 3D printed out an exact replica of it. This 3D printed skull allowed surgeon Jonathan Britto to use a clay-like substance to design a small mound that could be replicated in medical grade material and then implanted in the area of the face where they will gradually be building up Tessa’s nose.

An incision behind Tessa’s hairline was made and the implant was then inserted, leaving no visible scarring whatsoever. This is just the very first of what will be many surgeries that she will undergo in the coming years.

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The gradual process will ensure that her nose grows at the same rate as the rest of her face, until her body has pretty much stopped growing. At this point in time — sometime in her teenage years — Tessa will receive a final prosthetic implant.

tessa7“In the past attempts to rebuild a nose would leave scars on the face,” Britto explained. “The “nose” would not function as an airway and they didn’t achieve a good aesthetic result. Teenagers would end up with something that didn’t look like a nose. With the new method, I’ll make a new implant as Tessa grows, at each stage in her growth. By the time she is adolescent I’ll have expanded the tissue. When she is a teenager I’ll make a definitive nose, and we’ll tattoo in nostrils and creases. I’m really excited about it. She won’t have any of the downsides of previous methods.”

Because this surgery will take place over the course of more than a decade, technology and more specifically, 3D printing should improve, thus providing surgeons with even more options in the coming years. If it weren’t for 3D printing, Britto would have had an extremely difficult time trying to model the implant that Tessa received. 3D printing allowed him to work on a model as if it was actually Tessa’s face.

“Tessa is like any other little girl, she loves playing with her brother and sister, she’s always smiling and has never let her condition stop her from doing anything,” said Grainne. “Everyone who meets her instantly falls in love with her, we just want her to inspire other people like she inspires us.”

What do you think about this incredible story? Discuss in the Little Girl Without a Nose forum thread on 3DPB.com.

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