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