Plastic surgeon helps save patient from permanent disfigurement
Patient of Courage: Carol Bryan

Although ASPS honors its Patients of Courage: Triumph Over Adversity Award winners each year at Plastic Surgery The Meeting, there are more patients of courage than are recognized on stage.

Carol Bryan underwent seven reconstructive surgeries after suffering a botched facial cosmetic procedure that resulted in severe facial disfiguration. ASPS member Reza Jarrahy, MD, associate clinical professor of surgery and pediatrics at UCLA, repaired some of her damage through corrective surgery. Carol credits Dr. Jarrahy and his team for helping her rebuild her life.

In Dr. Jarrahy's words

What went wrong

Several years ago, Carol began seeing a "cosmetic" doctor who was not a plastic surgeon and not board-certified. He began to inject her face aggressively, with questionable techniques and with non-FDA approved materials. She suffered horrific infectious and ischemic complications that severely disfigured her face and compromised her vision. Carol went from a fashion model to a recluse, refusing to leave her house for years due to the striking appearance of her face, and the comments it elicited from onlookers.

How we helped

Carol sent letters to some of the top reconstructive centers in the country; ultimately, she came to UCLA for a consultation. Together, we embarked on a multistage treatment plan to restore a more natural form to her face and improve her function. We first performed a forehead lift to try to improve her vision by elevating, excising and suspending the disease tissues that were obstructing her field of vision. Due to pre-existing optic nerve ischemia from her injections, this procedure left her blind in one eye.

However, she refused to give up. In our next operation, we removed all of the diseased tissue from the forehead and replaced it with a parascapular free flap. Once she recovered from this major surgery, we performed a facelift-type procedure to debulk the foreign material from her cheeks and improve her facial contours. She has subsequently had numerous revision surgeries.

The lasting effects of our work

Having completed this tough series of interventions, Carol has "come out of the shadows." For the first time in six years, she feels comfortable enough to leave her house without sunglasses. She is beginning to resume a normal life. Most impressively, she has decided that she wants to do whatever she can to help others who had the same erroneous impression she had – that injections are harmless and be performed by anyone – avoid the devastation she experienced. To that end, she has become a patient advocate and public speaker, helping educate others on how to choose the best and most-qualified practitioners of plastic surgery, and she's now launched Saving Face, a non-profit organization that provides support and advocacy for aesthetic safety.

Q&A with Carol Bryan

PSN: Can you talk about how difficult it was to find a surgeon to help you? How did you solicit doctors? Why would no one take the case?

Carol Bryan: After three-and-a-half years of undergoing various procedures to try to correct the damage – and actually having those corrections worsen the damage – my daughter, Sofia, begged me to get help. I didn't believe there was anyone who could help me, as the procedure performed on me was unprecedented. Sofia sent my photos to every teaching hospital in the country, and Dr. Jarrahy was the only doctor that agreed to help me. Although he wasn't sure how he could help me at that time, he vowed to try to give me a chance of being able to face the world again. Dr. Jarrahy presented my case to a congress of doctors to share my story, and only one other doctor agreed to help him – J. Brian Boyd, MD, Palos Verdes Peninsula, Calif., is one of the most renowned microvascular surgeons in the country and also from UCLA.

PSN: How many procedures did you have, and how long was the overall process?

Carol Bryan: My first surgery in April 2013 was to perform a forehead lift to improve my vision so that I could see how to walk. Unfortunately, the debulking process caused the foreign substance that was injected into me to dislodge and press against my optic nerve, which resulted in loss of blood flow. I ultimately went irreparably blind in my right eye during the first surgery. I had a total of seven reconstructive surgeries from April 2013 to September 2016.

PSN: How has Dr. Jarrahy played a role in your recovery process?

Carol Bryan: Dr. Jarrahy is the most amazing, compassionate plastic and reconstructive surgeon in this country, in my opinion. Dr. Jarrahy's willingness to take on such a high-risk case when most of his peers tried to discourage him was not only a huge challenge, but it also showed his bravery in doing so.

PSN: How did you go about building trust with a new plastic surgeon after your previous experience?

Carol Bryan: I didn't have any other doctors willing to help me. I trusted Dr. Jarrahy because I believed if he was going to take on my case, he was confident that he could help me face people again – no matter what. If he hadn't agreed to help me, I would still be greatly disfigured and most likely living in isolation. Dr. Jarrahy told me that there were many unknown risks, and I really had to just believe and trust in him. I also have great faith in God, and I felt that I was making the right decision.

PSN: Can you discuss your mission to help educate patients through your organization Saving Face?

Carol Bryan: I launched Saving Face in 2016 when I discovered there weren't any organizations in the United States that support or advocate for aesthetic safety. I searched for nearly two years to find a place of refuge and support to help me get through my very difficult plight. I felt it was my duty to bring awareness to as many people as possible and to advocate for the safe and ethical practice of aesthetic medicine. I know I am not alone. My circumstances may be different, but people need to come forward. They don't come forward to make a difference or change the regulatory issues because they are ashamed. There's nothing to be ashamed of. I do feel that the plastic surgery specialty is invaluable to our society. There's nothing wrong with enhancing or undergoing preventive procedures to age gracefully. Consumers and patients just need to do their due diligence regarding the procedures that will be performed, products being injected, and most importantly, making sure that the physician is qualified and has supervised training to perform such procedures.

PSN: How has reconstructive surgery helped you rebuild your life?

Carol Bryan: Had Dr. Jarrahy and Dr. Boyd not been the brave and confident experts that they both are, I would have isolated myself for the remainder of my life because I was so grossly disfigured from the procedures and corrections that were performed on me. I definitely would not have been able to face the world again without undergoing these reconstructive surgeries.

There really are no words to describe what both Dr. Jarrahy and Dr. Boyd mean to me. They saved my life and refused to turn their backs on me. They are my heroes. I know I have told them how much they mean to me, but they already know that and it goes back to the reason that they became doctors in the first place – to first do no harm and to never give up.