Nguyen Thi Phuong in 2009 before her first surgery (top), and post-op 5 years later in 2014 (bottom).

Nguyen Thi Phuong

When Phuong she was twelve years old her lower jaw began to swell. She lived with her impoverished family far away. They desperately hoped someone could remove her aggressive giant cell tumor, but they lacked the means to travel or pay for any operation.

Eleven years later Phuong joined this group of patients and her 3-pound tumor had invaded her mandible and threatened her life. Pale, anemic, and fearful, she watched as the specialists reviewed her CT scans. Each image was extraordinary, showing massive and "moth-eaten" bony tissue. She stoically acquiesced to what was life-saving — complete removal of her lower jaw and lower teeth.

On April 9, 2009, Dr. Randy Robinson was joined at the table by several surgeons, including Drs. Lam Hoai Phuong (NHOS Director), Chanh, Lam, and Viet. In four hours they performed their first-ever mandibulectomy. The team placed a titanium bone plate shaped like a mandible and two rib grafts to become her new jaw joints.

This surgery went smoothly and at this point Dr. Robinson stepped to the second tier so the Vietnamese surgeons could step up and close the incision. Stable, Phuong was transferred to the recovery room where we would meet her mother.

Perhaps 4'8", her tiny body trembled all over. She peered into the recovery room. This tiny woman was Phuong's mother. We invited her in. She took a few steps but only to see her daughter's gauze-wrapped face from afar. Phuong was sleeping quietly. With our encouragement, Phuong's mother stepped closer. She beheld her daughter, covered her own mouth, and sobbed. Gabi Stevens, PACU RN, surrounded this long-suffering mother in her long-armed embrace. Her burden lifted, this weary mother's humble gratitude poured forth:

"Thank you. Thank you. Thank you. Thank you. . . .I am so poor. We live far away. We have waited eleven years and now you have helped us."

When compared to the first photo of Phuong (2009) to the second (2014), not only do we see the loss of a massive mandible, but the return of a twinkle in Phuong's eyes!

Dr. Robinson said he would like to do some revision surgery in the future. But now while she is wearing her customized lower denture, he wants to let more time pass. If/when she has more surgery, she will need a new denture that fits the changes made by a secondary surgery. He wants to preserve the integrity of the titanium bone plate. Added surgery at this time may cause the plate to break.

Face the Challenge (FTC) was founded by Randolph (Randy) C. Robinson, MD, DDS, cranio-maxillo-facial surgeon, and his wife, Ginger Holmes Robinson, BSN, RN (cardiac and critical care). Since the late 1970's, they shared a dream to offer their medical services to the world's needy.
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