(NEW YORK) -- Cassidy Hooper has high hopes for a career in radio broadcasting, despite her physical challenges. The 16-year-old from Charlotte, N.C., was born with no eyes or nose.
She attends The Governor Morehead School in Raleigh, N.C., a residential K-12 school for the blind, but no challenge is too big for her: She runs on the track team and recently qualified for a scholarship to the Charlotte Curling Club.
And soon, by the end of the school year, she will have a new nose.
Since the age of about 11, Cassidy has gone through a series of skin graft and facial reconstruction operations at Levine Children's Hospital in Charlotte. In three final surgeries done over two to three weeks, doctors will stretch skin flaps over a bone or cartilage graft from another part of her body.
No one knows why Cassidy was born without eyes and a nose, a rare birth defect that likely occurred during the first two weeks of gestation.
"Her heart and brain are normal," said her mother, Susan Hooper, 42 and a kindergarten teacher. "Nothing else is going on with her."
From the moment she was born, her reconstructive surgeon, Dr. David Matthews, knew Cassidy would eventually have surgery, but had to wait until she stopped growing. He put in an expander to stretch the skin above her mouth and widened her face to create a bony opening, then an airway.
As a little girl, Cassidy had prosthetics for eyes, but at $5,000 a piece, the family could not afford to replace the custom-made eyes when she outgrew them.
"Insurance didn't pay one cent," said her mother. "We had already started the process to do her nose, moving her eyes closer together and having her skull reshaped. We were not going to pay for it then have to pay again."
She said once Cassidy's nose surgery was complete, they would buy new prosthetic eyes.
To be born with no eyes and nose is "exceedingly rare," said Dr. Sherard A. Tatum III, director of facial and reconstructive surgery at Upstate Golisano Children's Hospital in Syracuse, N.Y.
A member of the American Academy of Facial, Plastic and Reconstructive Surgery, Tatum volunteers with its Face to Face program, providing free facial surgeries to children in the Third World.
Building the foundation for a nose is complex, said Tatum, who does not treat Cassidy.
"The nose is a little like the ear -- what you see isn't functional," he said. "A lot of people have noses they lost to trauma and cancer and breathe fine and have a sense of smell. The nose is something we expect to see in its conventional place and it's good to put glasses on, but it's not 100 percent necessary."
"The nose is a bit of a tee-pee," said Tatum. "The soft tissues that make up the inside and the outside skin and mucus membrane don't have a lot of strength to stick out of the face like the nose does. You can't just slap some skin up there and make it look like a nose."
So doctors take a step by step approach, laying the inside membrane, then eventually using a combination of bone and cartilage from the skull or other part of the body for the structure and covering it with skin again.
These surgeries are successful, particularly in children.
"They're very healthy, don't smoke or drink and don't have artheroschlerosis," said Tatum. "They have tremendous healing power and are less likely to get infection."
The hardest part for children is the social challenges.
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