Surgeons rebuild child's face after car accident

A ten-year-old from south-central Missouri not only has a smile on his face after a devastating accident that nearly killed him, he has a new face altogether.

BryerJohn Bryer was critically injured just before Thanksgiving when a car ran a stop sign and slammed into the side of his family’s car. His mother, who was behind the wheel, and twin brother, Ethan, were not seriously hurt. John, on the other hand, suffered life-threatening injuries to his face, skull and brain.

Doctors in Springfield told John’s mom and dad that his head and facial injuries were very severe and that they should prepare for the worst.

"They didn’t give us much hope," says Ronda Bryer. “We did a lot of praying.”

John made it through emergency surgery in Springfield. After a week, he was strong enough to be airlifted to St. Louis Children’s Hospital where a team of surgeons, including plastic surgeon Albert Woo, MD and neurosurgeon Matthew Smyth, MD, began the very delicate task of putting pieces back together.

John was missing most of the bones of his face including part of his nose and the front of his skull.

"You could literally put your finger right on his forehead and press into his brain,” says Dr. Woo, pediatric plastic and reconstructive surgeon.

“We exposed most of the front half of his skull and top of his face, then created a new skull base with fragments of bone harvested from the back of his skull,” explains Dr. Smyth.

The team then created a new layer of soft tissue to protect John’s injured brain, and reconstructed a new forehead with bone salvaged after the accident. They also recreated missing portions of John’s face and forehead with bone harvested from John’s skull.

The operation was a success.


The image on the left is a pre-operation three-dimensional CT scan showing missing forehead, nose and orbit. The image on the right is post-operation; the forehead, nose and orbit were reconstructed with new bone harvested from the skull.

Today, John is catching up on his schoolwork, playing with friends, and back to goofing around with his brother.

“I’m so amazed,” says Ronda. “Everybody that sees him in town just can’t believe it. He’s done wonderfully.”

Dr. Smyth says, “This was very rewarding because of the trust placed in Dr. Woo and myself by the family, the excellent cosmetic and neurologic outcome, and the significant challenges we overcame surgically.”

“We were able to literally reconstruct his face,” says Dr. Woo, “to the point where he’s able to recover and hopefully live a normal life.”

John’s mother says it best, “Just look at him. He’s beautiful.”


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