Bradley Spencer, now 32, started noticing asymmetry on his left cheek in 2005. It caused some pain, but he put off seeking medical treatment because the discomfort was bearable and the asymmetry was not that alarming.
By 2009, the condition was more noticeable. Mr. Spencer’s primary care physician referred him to an ear, nose and throat (ENT) specialist, who confirmed the presences of a venous malformation (VM).
The most common type of a vascular malformation, a VM is caused by an abnormal creation and enlargement of localized veins. Most VMs are present at birth, but as in Mr. Spencer’s case, many are not diagnosed until adulthood.
The VM was close to Mr. Spencer’s facial nerve and treatment would cause a large scar, so the ENT specialist did not recommend surgical removal because of the risk of nerve damage and facial paralysis. Mr. Spencer resumed his life and went on to graduate school.
No Scarring, No Nerve Damage
Yet the asymmetry and the pain both got progressively worse. Last year, Mr. Spencer could no longer tolerate the condition. After some careful research, he sought a consultation with Paul Yang, MD, vascular surgeon at Lenox Hill Hospital, who referred him to Rafael Ortiz, MD, the hospital’s director of neuro-endovascular surgery and interventional neuro-radiology.
Based on Mr. Spencer’s computed tomography (CT) and magnetic resonance imaging (MRI) scans, Dr. Ortiz recommended a minimally invasive procedure called sclerotherapy and subsequent removal of the lesion.
“During sclerotherapy, the physician uses X-ray and ultrasound guidance to insert a needle into the venous malformation to inject it with saline [salt water],” said Dr. Ortiz. The VM then hardens, allowing a plastic surgeon to remove the malformation with minimal blood loss, he added. “This makes for a safer procedure and protects the facial nerve at the same time.” Dr. Ortiz performed the sclerotherapy this past winter, followed by same-day surgical excision. Nicholas Bastidas, MD, plastic/reconstructive surgeon, performed the latter procedure via an incision inside Mr. Spencer’s mouth, resulting in no visible scar.
Mr. Spencer’s now has a completely Lenox Hill Surgeons symmetrical face, with no loss of function in his facial nerve.
“I am so grateful to Dr. Ortiz and Dr. Bastidas,” said Mr. Spencer. “I did all of my research and everything the doctors told me about the treatment options and how the surgery would go, was absolutely correct. I have my confidence back. I have my face back!”