An extraordinary medical journey unfolds as devastating trauma—a 17-year-old girl's shotgun blast to the face—is transformed into renewed hope through groundbreaking facial reconstruction.

Dr. Long welcomes special guests Dr. Eric Dierks, an oral maxillofacial and ENT surgeon, and Dr. Larry Over, a prosthodontist specializing in maxillofacial prosthetics. Together, they unravel the remarkable case of a patient, whose face was catastrophically damaged by a shotgun injury that destroyed her nose, eyes, and significant portions of her facial structure.

The conversation takes us through the progressive stages of reconstruction, beginning with the initial life-saving surgeries performed by Dr. Bryce Potter and team, who created a new structural foundation using bone from the patient's leg. Two years later, when the patient was still facing profound disfigurement that caused public whispers and stares, Dr. Dierks stepped in to prepare her for a prosthetic solution.

What follows is a fascinating deep dive into both the surgical and artistic elements of facial prosthetics. Dr. Dierks describes creating a nasal airway that allowed her to breathe normally for the first time in years, while Dr. Over reveals the meticulous process of crafting a silicone facial prosthesis—from creating impressions and wax prototypes to custom-matching skin tones and placing artificial eyes with perfect symmetry.

Perhaps most compelling is hearing how this medical intervention transformed not just the patient's appearance but her entire life. The magnetically-retained prosthesis allowed her to blend into society as simply a blind person rather than someone with a visible disfigurement. She later established a long-term relationship and built a fulfilling life that would have seemed impossible in the aftermath of her injury.

This episode exemplifies the podcast's core mission: showcasing how collaborative expertise, innovative thinking, and patient-centered care can create outcomes that once seemed impossible. Listen now to discover how saving time saves lives, and how dedicated medical professionals can transform a flatline situation into a lifeline of hope.

To learn more about these life saving strategies and techniques, look for Dr. Long’s upcoming book, Flatline to Lifeline.

Follow us on X @DrLongPodcast

Producer: Esther McDonald

Technical Director: Lindsey Kealey, of PAWsitive Choices

Editing and Post Production: Adam Scott of Atamu Media Productions

© Flatline to Lifeline 2025

What happens when a 17-year-old girl arrives at the trauma center with her face destroyed by a shotgun blast? In this episode, we explore an extraordinary case that demonstrates why specialized expertise and immediate intervention make all the difference between life and death.

The shotgun injury created catastrophic damage, essentially removing the girl's face from the eyebrows down to the nose. Most trauma centers would have classified this as non-survivable. But Dr. Long assembled a team with unique qualifications—Dr. Bryce Potter, an oral-maxillofacial surgeon, and Dr. Mark Buehler, a microsurgery specialist—who approached this challenge with revolutionary thinking.

Instead of following the conventional staged approach to reconstruction, the team performed complete repair during the initial admission. Their philosophy? "A patient is never healthier than when they first present to the ER." By establishing an airway through tracheostomy, multiple specialists worked concurrently rather than sequentially, drastically reducing time to definitive care.

The cornerstone of the reconstruction was a "free flap"—living tissue transferred from the patient's leg that included fibula bone, soleus muscle, and skin. This complex microsurgery required connecting tiny blood vessels to maintain circulation to the transplanted tissue. When unexpected complications arose with blood flow during the procedure, the team's adaptability proved crucial.

The outcome was remarkable. Despite catastrophic facial trauma, the patient regained the ability to eat and speak. She went on to live a functional life for twenty years before additional cosmetic procedures, even having two children during that time.

Listen now to understand the extraordinary measures that transform seemingly hopeless situations into stories of survival and recovery. Because when the need is greatest, saving time truly saves lives.

To learn more about these life saving strategies and techniques, look for Dr. Long’s upcoming book, Flatline to Lifeline.

Follow us on X @DrLongPodcast

Producer: Esther McDonald

Technical Director: Lindsey Kealey, of PAWsitive Choices

Editing and Post Production: Adam Scott of Atamu Media Productions

© Flatline to Lifeline 2025

Caution: Graphic Medical Content. Listener Discretion Advised

A shotgun blast to the face at close range should've been fatal. Everything between her eyebrows and upper teeth was gone—eyes, nose, mid-face—yet somehow, a 17-year-old girl survived. This is the first episode in a three-part series exploring one of the most remarkable and complex facial trauma cases in medical history.

The secret to her survival? An extraordinary collaboration between specialists who weren't afraid to challenge conventional medical wisdom. Dr. Bill Long and Dr. Bryce Potter take us through this remarkable case where quick-thinking EMTs, who stuffed her facial cavity with sterile dressings to staunch the bleeding, innovative airway management, and revolutionary reconstruction techniques came together to save and rebuild a life.

What makes this story particularly fascinating is the counterintuitive approach to facial reconstruction. The maxilla, or upper jaw, was completely free-floating, no longer anchored to the base of her skull. In contrast, the mandible (lower jaw) remained attached. This meant the team had to begin by using the intact, still-connected lower jaw as the starting foundation to anchor and rebuild the entire face. The early placement of a tracheostomy, performed with a small incision in her neck to protect her airway, was a decision that faced significant criticism from other specialists. Yet, it proved transformative by allowing unrestricted access to the facial area for complex repairs and preventing her from drowning in her own blood.

This case also involved a unique collaboration between the trauma team and Oral and Maxillofacial Surgeons, as correctly aligning the mandibular and maxillary teeth was crucial to stabilizing the unstable maxilla. This was a pivotal step, as at the time, few plastic surgeons or ENT specialists had the training to perform this type of alignment. The old adage, "you can't sterilize the oral cavity," was a major challenge due to the high risk of infection in the open, bacteria-laden wounds.

The patient’s journey spans decades, from initial survival through multiple debridements to clear dead tissue and free flap reconstruction using the non-weight-bearing fibula bone from her lower leg. This graft was used to stabilize the critical upper mid-face bony structures and eventually rebuild the entire mid-face. This procedure, which involved an orthopedic and microvascular surgeon, required the detached flap to be brought to a new location and reconnected to the patient's artery and vein. The trauma team was also able to stabilize her blood pressure with transfusions, a crucial initial step to manage shock and prepare her for the long road of reconstruction. Her journey also included eventual prosthetic facial restoration using titanium plates and screws and magnets. Her two destroyed eyes were enucleated, and her case contributed to technological advances in 3D modeling that continue to benefit patients today. Most remarkably, she not only survived but went on to marry and have children, demonstrating the profound human impact of these medical innovations.

This episode illuminates how breakthrough medical approaches often emerge at the intersection of specialties when practitioners value patient outcomes over rigid adherence to established protocols. This is the first of three episodes on this incredible case, so stay tuned for the next two parts.

To learn more about these life saving strategies and techniques, look for Dr. Long’s upcoming book, Flatline to Lifeline.

Follow us on X @DrLongPodcast

Producer: Esther McDonald

Technical Director: Lindsey Kealey, of PAWsitive Choices

Editing and Post Production: Adam Scott of Atamu Media Productions

© Flatline to Lifeline 2025