‘Prosthetics help me face the world’

MASTER Sergeant Todd Nelson lost his right eye and ear in a flash when a car bomb in Afghanistan exploded, sending fire up his arm and over his head.

Although it’s taken years of painstaking work, the military has given him a bright blue eye and ear lightly freckled and pinked from summer sun. They’re not flesh and blood, but the glass and silicon replicas are so realistic, so perfectly customised, that they’ve given Nelson something else: the ability to face the world without shocking it.

“Honestly, people really don’t know it’s artificial,” said Nelson, whose injuries three years ago included third-degree burns, a skull fracture and broken jaw.

The wars in Iraq and Afghanistan have brought a new kind of patient to the facial prosthetics lab at the Lackland Air Force Base: wounded warriors, who have recently suffered heavy burns and multiple traumas.

The lab is one of two major facial prosthetic programs in the Defence Department, and it has seen an unprecedented new stream of wounded soldiers.

Before the wars, the 26-year-old lab’s patients were almost exclusively cancer and civilian trauma survivors, but “all of that prepared us for wartime, and that’s why our department is here,” said lab director Dr Joe Villalobos.

Wounded warriors make up about one-fifth of the roughly 425 patients they treat each year.

While the technology and capabilities at the lab are available in the civilian world, the Lackland lab has the expertise and resources to give soldiers the best possible care with little concern about the financial burdens that civilian trauma patients might face, Dr Villalobos said.

Patients at Lackland are treated with a combination of cutting-edge technology and carefully hand-hewed prosthetics.

Using specially-designed computer equipment, technicians can turn an MRI into 3-dimensional moulds and create custom-fit pieces to replace missing jaw bones or sections of skull for implant.

But sometimes, after patients have undergone life-saving surgeries and reconstruction work for basic functionality, aesthetics start to matter.

Soldiers tire of stares and flashes of shock on the faces of people unaccustomed to severe burn injuries.

“When your face is affected, you lose your identity,” said Dr Villalobos. “We address that here.”

Not everyone who loses an ear, eye or nose tip is interested in getting a new one. After the memory of what you used to look like begins to fade, “you start to accept who you are,” said Nelson, a 37-year-old Army mechanic from Colorado. And because burn patients typically undergo dozens of surgeries (Nelson is at 43 and counting), many are simply too procedure-weary to seek prosthetic ears or noses.

But Nelson said: “One of the things that bothered me the most aesthetically was the missing ear.”.

He knew getting a prosthetic right ear wouldn’t make a functional difference. If anything, the prosthetic has slightly dampened noises.

“It was for form, but I couldn’t help but want some of my form back,” said Nelson.

When a patient has one ear remaining, a mirror-image ear is created. Two missing ears are more difficult, said Dr Villalobos, but the lab has created ears using family as models.

One soldier wanted his father’s ears, so the lab took images and created versions that were smaller and less wrinkly to make sure the prosthetics were right for his age.

“If someone comes in and says ‘I want Clint Eastwood ears,’ we can do that,” the doctor said, grinning.


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