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Dr. Massry on Dr.90210 - Part 2 _ La Peer Surgery Center
Ok. Breathe. Take a breath. Two years ago, I was a plastic surgeon on
call, when Scott was brought into the emergency room. Heís been a charismatic handsome musician
when a horrific accident crushed almost all of his face. Some of the best doctors in Beverly
Hills had donated over a million dollars with this surgery, to reconstruct Scott. With his
wife and mother by his side, Scott has only a few more surgeries to go, before he can
move on with his life. In order for me to begin Scottís surgery, a breathing tube must
first be inserted into his card airways . This is a procedure called an ìawake intubationî.
This is a critical moment for a patient like Scott, but it must be done so we can operate.
You guys get this tube for me please. This tube.
Good job. Heís constantly breathing. Now weíre going
to put him on a mechanical ventilator and he did great. Usually this procedure, intubation
procedure, doesnít go this smooth on someone whoís had multiple injuries to their neck
and face. Weíre going to proceed with getting everything else set.
Iím going to perform the first portion of Scottís surgery today and what Iím going
to do is repair his eye socket, placed in the eye in about 4 to 6 weeks. It will take
about an hour. I think itís probably the simplest part of the surgery that weíre going
to perform today. Scottís socket is going to be reconstructed. He had his eye removed,
unfortunately, with his initial injury. The eye was not repairable, so Iím taking out
this plastic cell which is called a conformer. So with the scalpel blade Iím going to perform
an incision between the upper and lower lid. So Iíve now gained access into his socket
and this is the implant material that I would shape and stack on itself. Itís called porex.
It has pores in it, so blood vessels grow into it. So what Iím going to do now is stack
them on top of each other for building up his socket with building blocks. Hereís the
stack. Theyíre each a millimeter and a half thick. Iím going to stack as much as I can.
Hey guys. Hey. How are you?
I wanted to check on you. I need all the checking, believe me.
So weíre taking care of Scott pro bono, which means completely for free, so all of his work
is reconstructive also weíre putting our cosmetic ability here, not only our reconstructive
ability, to be able to rebuild his face. Letís start closing things. When weíre done
with this youíll see that itís going to look great, like no surgery was ever done
there. Itís perfect. Guys, we gave him a new socket! Weíre done. Just completed the
first stage of Scottís surgery. We fixed his socket, push his implant forward so he
can have a small eye painted in place. It went fantastic. Now itís on the Dr. Larian,
Dr. Cassileth to finish up with the surgery. The second stage of the surgery is about to
begin. Dr. Larian and I will be reconstructing Scottís nose. This is a pre-op photo. This
is just a mock post-op photo of what we want him to look like. This post-op photo is based
on old photos that Scottís mother gave me. He had a very nice strong bridge. He looks
like a model. The tip of his nose has collapsed down into his face, so he has a piece of cartilage
here, so weíre going to be building on that cartilage and we will also be rotating the
tip down. Okay. 9-15 blade. Iím amazed how much bone
he has here from our original operation actually. When I first met Scott he had a large hole
in his face that was peeled away. He had 2 large broken ribs as well, so when we went
into the surgery we took the broken ribs and use these as struts to reconstruct his face
and put the anatomy back together, and then flip the skin back over this new bone. It
was literally total facial reconstruction. Iím isolating the rib right under his scar,
so that we can take it for graft to use on the nose.
This is our rib graft. Weíre going to put the 2 pieces of cartilage
together like this, so that weíd go between the nostrils and they would support the top.
The larger piece was on the bridge of the nose to cover the nasal dorsum. So now the
cartilage graft is secure, so now weíre going to be working on the skin. These are the last
sutures on the nose. These are the final sutures on the ribs.
Houston, we landed! We just finished Scottís surgery. We think
it went really well. Our goal was to give him a good nasal dorsum and the bridge of
his nose back and support it. The dorsum that we created is really strong
and gives him a good profile, thereís no complications . It went very smoothly.
Itís all done? Itís all done.
Iíve got cottonmouth. Your nose looks really good. Iím very happy
about it. Both of us. Does anything hurts?
No. Wonderful. Perfect. Okay.
Scott, heís nearly at the end of the road. Heís still got a few things to go and then
heíll be at a point where heís finished. Itís very rewarding to be able to bring someone
back to normal, so heís been great to take care of. Itís been really rewarding to be
his doctor. Hi honey. Are you in pain?
Yeah. You have a nose again.
His new nose looks, definitely looks like a hundred times better than it did right after
the accident. Iím really excited. He has this greenish yellow color in his eye.
He has a lot of it actually underneath. This is and itís used to simulate the vascularization
in the eye. And so, itís ready to try in. Here you go.
Awesome. Wow. Itís amazing. You canít even tell. That is just incredible.
Oh my god. Itís so real. Itís so weird. It looks just like your eye. You did such
a good job. Itís so amazing. Itís so weird. It makes such a difference.
It does. It does. It changes his whole appearance. Iím going to get my smile back.
Youíre almost put together. Little pieces of the puzzle are all coming together.
Put little humpty dumpty back together. When Scott got his teeth I told him we were
going out for a steak and crab legs; and his favorite place has always been Joeís crab
shack. We wanted to have Dr. Cassileth there. This would be the first steak and crab legs
Iíve eaten in almost 2 years. For the longest time through all the surgery
he had his mouth wired shut and eating baby food.
Itís great being able to chew again. These surgeries had given me everything back, just
made all the difference in the world and how I feel and how I function.
Whatís your 1 year plan, Scott? Iím just trying to exercise and get back
in shape. Which is amazing to me. I mean an year and
a half ago when you were first injured. I mean the fact that weíre actually staying
here talking. Luckily you were the one that was working
that night. Thank you, but I donít want to see you back
there again. I hope so.
People that see me now are very amazed of how far Iíve come. Thereís so much for me
to be thankful for. There was a time when I just wanted to completely give up, I didnít
care about anything, I just wished that I have died but now after all the surgeries
Iím glad they saved me and Dr. Cassileth has helped me in every way. Sheís done an
amazing job in reconstructing my whole face. All the doctors and everybody are truly amazing
people. Theyíre really true caregivers. I never thought that I would even look anything
close to what I did, and itís just great. Okay guys. Iíd love to see you back at the
office at some point. Come see me in a couple of months.
Just being able to look in the mirror and recognize myself again is just amazing