- 6 weeks ago
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00:00You
00:05You
00:10I
00:12Use my head to kind of like cover my kids
00:15It doesn't cover it completely, but it's definitely
00:20A lot better
00:22It helps
00:24Like with the staring
00:25People
00:29Like
00:30Disgusted by it
00:31And have told me
00:33Oh, if I looked like yo
00:35I wouldn't leave my house
00:38There's certain days I've just cried
00:40Myself to sleep
00:44You just keep
00:45Thinking
00:46This is it
00:49I'll have to live with it
00:50For the rest of my life
00:54I just want
00:55To have my normal face
00:56Yeah
01:00I
01:01I
01:02I
01:05Look I
01:11It's so cold.
01:12It's so cold.
01:13Look at this rain.
01:15Wait for me!
01:16Wait for me!
01:17Oh my god!
01:18Get on the ground!
01:19It always...
01:20It takes me so long when it rains.
01:22That is why I check the weather forecast.
01:24I never...
01:25I never do.
01:31Did you make pilates this morning?
01:33Yeah, can you tell when I stood up?
01:35Yeah.
01:36It's actually the legs.
01:37They're sore.
01:40There's some new stuff in the morning.
01:41Literally, I didn't put this in the ground.
01:43It was wonderful.
01:44Let's put لو-
01:45Oh my god!
01:50I think I took too many. I'm going to put that one back.
01:55I'm going to put that one back.
02:00I'm going to put that one back.
02:05Oh, look at that.
02:07Oh, that photo's nice.
02:08Yeah, very nice.
02:10Look.
02:14Yeah.
02:15I'm going to put that one back.
02:19This is...
02:20At the shop.
02:21Yeah.
02:24I'm ready.
02:25You let me put it up in the shop.
02:28Yeah.
02:31Oh, you're smiling.
02:34You're...
02:35I'm going to put my face everywhere.
02:36It's little.
02:39When I was young...
02:40I was younger.
02:41I was more, like, confident.
02:46I'm, like, happier in general.
02:48Wow.
02:49Time for...
02:50I'm going to fly fast.
02:52Yeah.
02:53Stop taking photos.
02:55Really, at the start of my early teenage years.
03:00No.
03:01Due to the keloids growing.
03:02It makes me angry because it affects you.
03:05mentally, socially, everything you do is there.
03:10I just don't like it.
03:12And...
03:13I just feel ugly.
03:15I have a skin condition called keloids, where it's a...
03:20growth of scar tissue.
03:22So, over time, it slowly keeps growing.
03:25I keep growing and keep growing.
03:27It feels quite, like, thick and...
03:30tough.
03:31Sometimes it can give, like, a really, like, sharp pain.
03:35I'm packing to go to London.
03:38I'm packing to go to London.
03:41Um...
03:42for an appointment to see Dr. Emma.
03:45I'm nervous for the appointment.
03:47Just wondering what Dr. Emma will say.
03:50So that she can treat the keloids.
03:55So, Emma has two surgeries.
03:59So, Emma has two surgeries.
04:00One this morning and then one this afternoon.
04:01Okay.
04:02And then in between, we have Zoe and...
04:05it looks like she's quite an interesting case.
04:07Okay.
04:08So, I will book a double slot then.
04:09Perfect. Thank you.
04:10See you.
04:11See you.
04:15Bye.
04:16Bye.
04:17Bye.
04:18Bye.
04:19Bye.
04:20Bye.
04:20Bye.
04:21Bye.
04:22Bye.
04:23Bye.
04:24Bye.
04:25Bye.
04:30Bye.
04:31Bye.
04:32Bye.
04:33Bye.
04:34Bye.
04:35Bye.
04:35Bye.
04:36Bye.
04:37Bye.
04:38Bye.
04:39Bye.
04:40Bye.
04:41Bye.
04:42Bye.
04:43Bye.
04:44Bye.
04:45Bye.
04:46Bye.
04:47Bye.
04:48Bye.
04:49Bye.
04:50Bye.
04:51Bye.
04:52Bye.
04:53Bye.
04:54Bye.
04:56Bye.
04:55Bye.
04:56Bye.
04:57Bye.
04:58Bye.
04:59Bye.
05:00Bye.
05:01Bye.
05:04Emma.
05:05Bye.
05:07Hey, we've got 20 minutes before Zoe comes.
05:08Do you want me to get you anything?
05:09No, no.
05:10I am finished.
05:11Bye.
05:12Bye.
05:14Bye.
05:15Bye.
05:16Bye.
05:17Bye.
05:18Bye.
05:19Bye.
05:21Bye.
05:33Bye.
05:34Hello, my name is Zoe. I'm here to see Dr Emma.
05:37Fantastic. If you just take a seat, I'll let...
05:44Oh yeah, that's when it started.
05:47That's right, when it started.
05:48When I had it...
05:49Like this then, it bothered me.
05:53So it wasn't even...
05:54Not even that many.
05:55But now it's obvious.
05:57And because it's on your face...
05:59This is the first thing that people see.
06:01Yeah.
06:04I think it's boring, A's not.
06:09I need...
06:10I need...
06:11I got a shoe when I came to sleep.
06:16Be ready for the bar mode tell it never gets me...
06:32come on have a seat thank you this is multi he's our nurse hello
06:37thank you this is zoe and mom so zoe
06:42i can see why you've come to see me in the clinic today yeah tell me a little bit about these
06:47scars on the face so i had acne during my early teenage years
06:52and then that developed into keloids and does anyone else in the family have
06:57problems with developing keloids at that side of the family okay but
07:02it's very like very very mild i seem to be like affected really severely yeah
07:07yeah okay and did these keloids come up just in like little bumps
07:24you
07:12initially yeah but that's when i started to seek treatment and and what
07:29you
07:17treatment were you given so i was given surgery i've had three
07:34you
07:22and do you have any photographs of these just so i can get an idea of what it was like before
07:39you
07:40it was in surgery where was that the bottom here okay i decided to just remove one
07:52you
07:53you
07:45the last one they removed all the keloids and how long ago did they do that five
07:49years that's really helpful to see and see you know how much they've grown
08:02you
08:03you
08:04you
08:08you
08:09you
08:10you
08:12you
08:20you
08:22you
08:24you
08:13It must be difficult to have something that's painful and so visible for everyone.
08:18To see, how does it affect you?
08:20Confidence.
08:21When she was, she was loud.
08:23You know, giggly, playful and then suddenly because of...
08:28...things that people say, she started, you know, retreating a bit.
08:33It's hard to see as a mummy, isn't it?
08:35Yeah, it is.
08:36Okay, do you mind if I come and have a...
08:38...a close-up look at all of these?
08:39Is that okay?
08:40Yeah, that's okay.
08:43Okay, let's have a wee look at this.
08:47So, this is...
08:48...is actually really all merged into be one giant keloid, isn't it?
08:53Yeah.
08:54It's got a real overhang of where it's just dangling down.
08:59It's on a stalk.
09:00I can get my fingers right underneath that.
09:04And then it's attached all the way on the cheek area.
09:07Nice.
09:08Actually, that's one active little spot there.
09:12Yeah.
09:13So, you move around to this side.
09:14These are still distinct separate ones.
09:16So, you've got one...
09:18...two...
09:19...three...
09:20...four...
09:21...and then the one underneath it.
09:23...kitchen...
09:24...five...
09:26...and actually just noticing.
09:28...the little hairs.
09:32Undoubtedly, these are...
09:33...keloids.
09:34So, when we think about what a keloid is, usually there has to be an injury to the...
09:38...skin to begin with.
09:39So, sometimes it's an acne spot.
09:41Sometimes it's a cut.
09:43Sometimes it's even as simple a thing as a hair being trapped.
09:47And no...
09:48Normally, whenever we have a wound, our fibroblasts, which are our cells repair wounds.
09:53...kick in.
09:54Repair it.
09:55And then they go, okay, we're done, we're repaired.
09:58We can stop.
09:59But when somebody has a tendency to keloids, those fibroblasts...
10:03...just keep on making more and more scar tissue.
10:07You probably...
10:08...harry one of these genes that have got a tendency to develop keloids from...
10:13...your father's side of the family.
10:15What's caused the keloids that you have now?
10:18...has really been these surgical interventions.
10:21Because whenever you do surgery...
10:23...on a keloid, you're essentially making an even bigger wound.
10:28...that can result in another keloid.
10:30Yeah.
10:31Not having anything afterwards.
10:32Yeah.
10:33...has then undoubtedly meant that the recurrence risk was going to be higher and...
10:38...and here we are now.
10:39Another factor, I think, of what's potentially driving it for you...
10:43...is a hormonal factor.
10:45Has anybody ever looked at your ovaries?
10:48...to see if you've had any cysts on the ovaries?
10:50Something called polycystic ovarian syndrome?
10:52No, I'm...
10:53...has ever, like, tested me for that.
10:55Or even said, you have it up.
10:57Okay.
10:58Yeah.
10:59Because we know for people, well, women who have...
11:03...keloid scars, they are worse whenever the hormones are a bit out of balance.
11:08...with something like PCOS, polycystic ovarian syndrome, that drives...
11:13...acne, and it also is the driver for why people often have hair in...
11:18...areas that they don't necessarily want to have hair.
11:21So, I think with this...
11:23...the condition of PCOS, which I think you do have, a really important step...
11:27...will be to get the...
11:28...hormones exactly in balance.
11:30It's an injection to reduce the acne.
11:33...to reduce the bits of hair growth.
11:35So, that is step one.
11:37And then step two...
11:38...this is a big job, and this will require...
11:43...quite a bit of planning.
11:44So, I would like you to see my colleague, who's a specialist in facial...
11:48...plastic surgery, to see, you know, how is this possible?
11:53And...
11:53...and then there is no way you can have any surgery on your skin...
11:56...unless you have...
11:58...something like post-operative radiotherapy to try and stop these from coming back.
12:02Yeah.
12:03And that's the thing that's associated with the best cure rate.
12:06Does that make sense to you?
12:08Yeah.
12:09No-one has ever thought about the problems within me.
12:13I feel like before...
12:15Yeah.
12:16...just get surgery and then that's it.
12:17Yeah.
12:18Surgery alone is absolutely never the answer.
12:23Ever.
12:24And it just makes things worse.
12:28Zoe is just 20 years old and she has one of the worst cases of...
12:33...facial keloids I have ever seen.
12:35The thing is, our face is really our identity.
12:38It's how we think of ourselves and it's how others view us and interact with us.
12:43And so no wonder this has had such a devastating impact on her.
12:47I really want...
12:48...to be able to help her.
12:49What's a dream to catch?
12:51But she's already had.
12:53Three failed surgeries and each time the keloids have come back and they've come back...
12:58...bigger than before and now virtually both of her cheeks are just scarred.
13:03...or tissue.
13:04OK, I need to get a taxi.
13:06Removing these keloids is...
13:08...is going to be a complicated surgery and the big challenge is going to be closing up.
13:13...those wounds and leaving as little scarring as possible.
13:18And I think it's going to take a lot out of her emotionally and physically.
13:23...
13:28You
13:33Can I take a message?
13:38Zoe suffered with keloids for pretty much her entire life.
13:43And previous attempts to try and remove these have just resulted in
13:48them growing back even bigger.
13:50So she needs a very specialised
13:53and complicated surgery.
13:55And I'm referring her to the brilliant and very experienced
13:58plastic surgeon, Mr. Simon Withey.
14:00Dear Simon, I'm most grateful for you seeing my page.
14:03Thank you so much.
14:08And I think we need to make a plan of how to treat these different
14:13definitively with counter-guard your sincerely.
14:18Zoe's really quite reserved, isn't she? Very, very self-contained.
14:23I think that's quite common after teenagers have experienced that kind of trauma.
14:28And almost like, I don't know, keeping everything inside.
14:31Yeah, I've noticed that, like a protective...
14:33kind of layer?
14:34Yeah, that's exactly what it's like.
14:38I don't know, too.
14:39I don't know, too.
14:40That's all I'm worried about.
14:41Go out, too.
14:42I'm worried about how to treat these different things in a kitchen.
14:43I don't know if it's just a busy day.
14:44I don't know if it's good.
14:45It's just people who are actually quite as well.
14:46I'm wrong.
14:47I just don't know if it's working at me or not.
14:48But I'm not even in my room.
14:49I don't know if it's doing a hotboard.
14:50I don't know if it's in school today.
14:53I don't know if it's in high school.
14:54I feel so stupid.
14:55You know, I don't know if it's in my house.
14:57I don't know if it's in school.
14:58I don't know if it's in school without having trouble.
15:00which are becoming ingrown, and that is what the trigger is for the keloids.
15:05It's vital to get this under control before her surgery, so I'm starting her own.
15:10Some treatment to balance the hormones and reduce the risk of her developing new keloids.
15:15So it comes in a pen, press my stomach, and then inject.
15:20Yep.
15:25I have an appointment with my...
15:30Dad, to go and see Mr Worthy.
15:35Hello, my name's Zoe.
15:38I'm...
15:40I'm really hoping that he's going to agree that further surgery and the right aftercare...
15:45is going to be the best option for Zoe.
15:47Nice to see you, Zoe.
15:48How was your journey?
15:50Feels good.
15:51Good.
15:52Can I ask you to come over to the couch?
15:55The bit which is attaching...
16:00the scar to the skin is, fortunately, a little bit smaller, which is quite...
16:05helpful when it comes to deciding whether we can take these out.
16:10Thank you so much.
16:12Thank you so much.
16:13Come and have a seat.
16:15I think surgery is the solution for...
16:20removing these keloids.
16:21Yeah.
16:22I think there are areas which worry me.
16:24Why...
16:25One is the widest bit of the scar on the left side.
16:29The base...
16:30that it's growing from is really very significant size.
16:34Thank God.
16:35And it is quite possible that we wouldn't be able to close.
16:40the wounds at the time of your first operation.
16:43What I propose, having seen you today...
16:45is to talk to Dr. Emma.
16:48Yeah.
16:49And then I think we'll meet...
16:50together where we discuss whether we do the operation as well.
16:55one stage or two stages.
16:56All right.
16:57Yeah.
16:59All right.
17:00It's a pleasure.
17:00The thought of two different surgeries makes me feel nervous.
17:06You let your mom know about it.
17:09Well, just how...
17:10keeping now knowing that...
17:11it is possible...
17:12to now get surgery.
17:14And...
17:15um...
17:16yeah.
17:17So what did you say?
17:19So what did you say?
17:20He said that he can do it.
17:21So it's brilliant news.
17:23I'll speak to you...
17:25I'll see you soon.
17:26Bye.
17:30Bye.
17:35Bye.
17:40Bye.
17:41Bye.
17:42Bye.
17:43Bye.
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18:55solution should we have a look at the other cheek and this is the big one so
19:00it's possible that when you take this out you can sort of get something which
19:05might just approximate and close the wound but it might not
19:10if we feel it's not going to occur
19:15we will take the majority of this out leaving a little bit of scar tissue
19:20behind before a second operation and how long do you think it would be between
19:25the first and the second one three or four months minimum maybe
19:30extending to six months you do feel the responsibility of making sure that it's
19:35as good as it can be because it's probably the last go surgically it's a lot of
19:39pressure
19:40on you
19:41and you
19:45i'm so pleased mr withy once
19:50to operate on zoe because this is a really complicated case until he removes
19:55the keloids he's not going to know if there's enough healthy skin underneath to
19:59close this over
20:00in which case zoe would require another operation in six months time
20:05but this would mean delaying one of the radiotherapy treatments which would increase the
20:10risk of the keloids coming back
20:13even with just one surgery we know
20:15that there's not going to be enough healthy tissue left for any more attempts after this
20:20this is her one and only chance and we have to get this right
20:25so
20:26you
20:35I do.
20:40I love training to be a nurse, but it's really pushing me out.
20:45I love my comfort zone.
20:50Morning.
20:52Morning.
20:53To the hospital, please.
20:54Yeah, no problem.
20:55I feel like patients expect a nurse to look a certain way.
21:00So when they see me, they think that I'm not going to do...
21:05..as good of a job as maybe another student.
21:11Bye.
21:12So have...
21:14..so have one year, and then I'll be a qualified nurse.
21:18I do hope that if the kilos are gone, I can just be...
21:23..a bit more confident.
21:24I'm just hoping to just live...
21:27..a bit more, just be more happier, wanting to, like...
21:32..do things that I've been putting off doing.
21:37.
21:38.
21:42.
21:44..and that's brilliant.
21:45Yeah.
21:47Bye.
21:48That's Mr Withy.
21:49He's just...
21:50..for Zoe.
21:51And we've got a date for surgery.
21:52Oh, that's amazing.
21:53Yay!
21:55.
21:56.
21:57.
21:58.
22:00.
22:03.
22:04.
22:05.
22:06.
22:05.
22:08.
22:09.
22:10.
22:11.
22:12.
22:15.
22:16.
22:17.
22:18.
22:26.
22:28.
22:30.
22:32Let me show you to your room.
22:33So make yourself comfortable.
22:36How you feel?
22:37What are you feeling today?
22:38A little nervous.
22:40I'm gonna look after you.
22:42I want to see you next time.
22:47How are you?
22:48I'm welcome.
22:49Good.
22:50Any questions?
22:51Um...
22:52Are you able to do both sides of my face?
22:54I'm hoping we'll be able to take everything away.
22:57But I really...
22:58I can't make any firm promises.
23:00Okay.
23:01How long do you think the operation will take?
23:04Good question.
23:05I don't know.
23:06Um...
23:07It's not gonna be shorter than three hours.
23:09I mean, it could be as long as...
23:11Sort of five...
23:12Five hours.
23:13Yeah.
23:14I think...
23:15We've got the rest of the day.
23:16All right?
23:17Yeah.
23:18We've got the rest of the day, right?
23:19Yeah.
23:20And...
23:21You're ready to go?
23:23Yeah.
23:24A kiss?
23:25Good luck.
23:30We'll look after that.
23:35This is the largest
23:40special key load I've removed.
23:42If we take it all out,
23:45but can't close the wound,
23:47we've completely messed up.
23:50We'll see you next time.
23:55You
24:00You
24:05So we have one patient, Zoe,
24:07who is 20 years old, I think.
24:09Yep.
24:10Who is coming in for excision
24:12of facial keloids,
24:14given
24:15that she has already had surgery,
24:17her keloids have come back very aggressive.
24:20There is one attempt at doing this.
24:23So we're just going to do that.
24:25Safety checks.
24:26Okay.
24:27And then put the drip in,
24:28a bit of oxygen,
24:29and off to sleep.
24:30Okay.
24:32So the decision is,
24:33can we cut it all out today?
24:34Try and
24:35minimize the amount of operations for her?
24:38Do we have to leave a bit behind?
24:40How do we
24:40do we get the bits back together?
24:42So you might be starting to feel a little bit sleep.
24:45I'll keep you now.
24:49Pleasant
24:50in your dreams
24:51and we'll take good care of you.
24:52Okay.
24:55Bye.
24:56Bye.
25:00Bye.
25:01Bye.
25:02Bye.
25:03Bye.
25:04Bye.
25:05Bye.
25:05Bye.
25:06Bye.
25:07Bye.
25:08Bye.
25:09Bye.
25:10Bye.
25:11Bye.
25:12Bye.
25:13Bye.
25:14Bye.
25:10I'm also doing that mixture of excited and nervous for her, because there's no room.
25:15For anything to go wrong.
25:17Good luck. Thank you. See you tomorrow.
25:19See you tomorrow.
25:20Bye-bye.
25:25Facial surgery carries...
25:30...especially high stakes, because our face is the most visible and personal part.
25:35...of who we are.
25:36Studies show that when done well, scars that are replaced...
25:40...properly and they've healed discreetly, have very little impact on how a person...
25:45...can live their life.
25:46One, two, three.
25:48But poorly placed guards...
25:50...can deeply affect a person's confidence and well-being.
25:53So there really is no room.
25:55...for error.
26:00The plan is to start on the left-hand side.
26:03This is the more challenging...
26:05...one.
26:06Work out how much of the scar I can confidently take.
26:10...without risking having an open wound...
26:13...and then fit the bits back together.
26:15You can see there are a few little smaller scars.
26:20...on the cheek.
26:21Those are going to have to be left, unfortunately.
26:23Taking them just means that...
26:25...I end up really struggling to close things.
26:30They're getting bored from them.
26:31At...
26:32...it helps them...
26:33...without Africans.
26:35collect some local anesthetic and a bit of fluid.
26:40Separate the scar from the layers in the cheek.
26:45.
26:50Oh, goodness.
26:52Skull seems quite...
26:55Oh, goodness.
26:58This kind of isn't getting in.
27:00Normally, the tissue plate...
27:05...the vein will open up...
27:07...based on the sort of pressure of the fluid being injected.
27:10Here, it's just coming out back through the hole.
27:15I made to put the cane in red.
27:20More scarred, deeper down than I thought.
27:25It hasn't lifted.
27:27It hasn't done the job.
27:29I thought that might ease the operation.
27:30For us a bit.
27:32So I'll have to do that surgically.
27:33Just take a bit longer.
27:36Cut through the skin out.
27:39The fact that...
27:40...the fluid didn't go in...
27:41...means that the tissues are quite tightly adherent...
27:44...and scarred to one another.
27:45It's certainly not an easy tissue plane to dissect.
27:50Just trying to make sure we lift this up without...
27:55Getting too deep, effectively.
27:58There's a little branch of the facial nerve...
28:00...at this level.
28:02If we get that...
28:03...then it gives her an imbalance.
28:05There's a sense of smile.
28:06So, very keen to avoid it.
28:10Do I leave?
28:14Do I leave?
28:15Do I leave a bit behind?
28:17Am I...
28:19...reasonably confident?
28:20That we're going to be able to...
28:22...lose this.
28:25So we're close to getting this off.
28:31Last little bit.
28:33Little bit here.
28:34There we go.
28:36That's Herkeloid.
28:37That's Herkeloid.
28:40So now I've got to...
28:44So now I've got to...
28:45...try and close it.
28:50If you can just pull a bit on the cheek.
28:56We have been building up to this day for so many months.
28:59This means...
29:00...so much.
29:01And this is her one shot...
29:03...of this working.
29:04And so...
29:05...so that's why I have to be here.
29:08I'm anxious about this.
29:09Because this is so...
29:10...complex.
29:14Hi, thank you.
29:15Hi, Simon.
29:16Hi, Emma.
29:17So how is it all doing?
29:19Obviously getting...
29:20...the two edges of this together is difficult.
29:23It's amazing when you take all the scars...
29:25...how much it then suddenly...
29:26...just opens itself out, isn't it?
29:27Yeah, exactly.
29:31Do you think you'll be able to remove...
29:32...all of these today?
29:34I'm hoping...
29:35...so, yeah.
29:36Oh.
29:38Just tacking the edges...
29:40...together to see how it best fits.
29:45It looks like we might close it.
29:47Yeah.
29:48It looks like we might close it.
29:49Yeah.
29:51I can breathe now.
29:52Yeah.
29:54It's obviously very...
29:55...very tight.
29:56You know, if you took another...
29:57...a couple of millimeters each side...
29:59...you might get a slight...
30:00...likely better quality of edge skin...
30:02...but I'd rather have this...
30:04...than overdo it.
30:05...and therefore increase the risk of...
30:08...further scar thickening as a result.
30:10...of the increased tension.
30:11Yeah, I think that's exactly right.
30:12I think we'll accept what we have.
30:16I mean, Zoe is going to be so pleased...
30:18...that this is not there on her face.
30:21One side, almost done.
30:23One last stitch.
30:24Yeah.
30:25It looks so good.
30:28I'm going to go and update Zoe's mum.
30:30Thank you, everyone.
30:31Emma, thank you so much for joining us.
30:34Bye.
30:35Bye.
30:40Hi, Agnes.
30:41Hello.
30:42Hello.
30:43How are you?
30:44I'm good, thank you.
30:45It's so good to see you.
30:46So, I just thought I'd come and update you.
30:49So...
30:50The side that was the quite complex side...
30:52Yeah.
30:53...and Mr. Withy wasn't sure...
30:55...whether he needed to do two operations on it.
30:57Yeah.
30:58He's actually able to get...
31:00...all of it gone.
31:01Just...
31:02That's exactly what I thought.
31:03That's what I thought.
31:04Yeah.
31:05And he's done a closure of it as the scar...
31:08Yes.
31:09...and it sits quite neat...
31:10Oh, God!
31:11That disorder!
31:12Yeah.
31:13Because as I sat here, all our...
31:15...what I've been thinking is...
31:16...where will the scar be?
31:18But...
31:19Oh...
31:21So, what's up with the other side?
31:22So, he's just starting that one night.
31:24I do.
31:25Bye.
31:25Okay.
31:30Bye.
31:31Bye.
31:32Bye.
31:33Bye.
31:34Bye.
31:35Bye.
31:35Bye.
31:36Bye.
31:37Bye.
31:38Bye.
31:39Bye.
31:40Bye.
31:41Bye.
31:42Bye.
31:43Bye.
31:45Bye.
31:47Bye.
31:48Bye.
31:49Bye.
31:50Bye.
31:52Bye.
31:53Bye.
31:54Bye.
31:55Bye.
31:57Bye.
31:58Bye.
31:59Bye.
32:00Bye.
32:05Bye.
32:10Bye.
32:12Bye.
32:13Bye.
32:14Bye.
32:15Bye.
32:16Bye.
32:17Bye.
32:18Bye.
32:20Bye.
32:22Bye.
32:23Bye.
32:24Bye.
32:25Bye.
32:27Bye.
32:28Bye.
32:29Bye.
32:30Bye.
32:30Bye.
32:31Bye.
32:35Bye.
32:36Bye.
32:37Bye.
32:38Bye.
32:39Bye.
32:40Bye.
32:40Bye.
32:42Bye.
32:43Bye.
32:44Bye.
32:45Bye.
32:47Bye.
32:48Bye.
32:50Bye.
32:51Bye.
32:55Bye.
33:00Bye.
33:01Bye.
33:02Bye.
33:03Bye.
33:04Bye.
33:05Bye.
33:06Bye.
33:07Bye.
33:08Bye.
33:09Bye.
33:10Bye.
33:11Bye.
33:12Bye.
33:13Bye.
33:14Bye.
33:15Bye.
33:16Bye.
33:17Bye.
33:18Bye.
33:19Bye.
33:20Bye.
33:21Bye.
33:22Bye.
33:23Bye.
33:24Bye.
33:25Bye.
33:26Bye.
33:27Bye.
33:28Bye.
33:29Bye.
33:05The difficulty is to be working out how you're going to put this back together again.
33:10The difficulty is to be working out how you're going to put this back together.
33:15Anyway, we're committed now. We've got to do it.
33:20No choice.
33:25The surgery on the left side, the surround...
33:30The surrounding tissues move together in a reasonable fashion.
33:34You can see...
33:35It's quite complicated. It's a little, sort of, more of a jigsaw puzzle.
33:40This side, which is why I'm going to be tacking a little bit back.
33:45Before I fully close anything, just to make sure it does work.
33:50There's a black cheek.
33:51I'm going to let you see a little bit of information here.
33:53I've got this one more time.
33:54I have to make sure it's nice.
33:55I love you.
33:56I want to make sure I'm going to put a little bit of water.
34:00I want to make sure I can clean the room.
34:02You give me some water.
34:05I love that you're going to make sure I've got it.
34:08There's a lot going on.
34:09I think I'm going to be runnin' like that.
34:10I think that it's a bit easy.
34:12I'll just keep the time out of here.
34:15If you want to make sure they'll keep those hours and stop forgetting.
34:17I'll see you next time.
34:22I'll see you next time.
34:27It's too tight.
34:32It's too tight.
34:37Quite tight in the middle.
34:43Try to see how else I might address that.
34:46I could have a mark.
34:47I'm just not convinced that's the healthiest.
34:52It's too tight.
34:53I'm just taking out corny's beasts.
34:57Do I think it is?
35:02I'm going to advance this.
35:08Flat across this bit of tissue.
35:11I'm just going to take...
35:12Take the tension off.
35:15A bit of dead tissue would...
35:17Be catastrophic for her.
35:22So...
35:23I'm happy with the tension now.
35:26This is the...
35:27The best alignment we can get of these tissues.
35:31And so...
35:32I'm going to formally close this wound.
35:37It's been a very long...
35:42surgery.
35:43I'm so desperate to see her.
35:46I might...
35:47Just...
35:51Putting the...
35:52Last layer of sutures in now.
35:55It's been a bit fiddly.
35:56Particularly this...
35:58So I'm quite relieved.
35:59It has come together.
36:01I had a moment...
36:02A moment of doubt.
36:04I had a moment of doubt.
36:05Full stop.
36:07Let's go...
36:08I had a moment of doubt.
36:09But there will be the best alignment once...
36:10We're stuck somewhere.
36:11Fair enough.
36:12Or...
36:13Atop Armand.
36:14On the other end...
36:15It's over with ourzeroes.
36:16In we still have a Potter.
36:17After all it is.
36:19pathways.
36:20There are still many short stories.
36:21Do you have to find other spots.
36:22We hurt to find eye for you.
36:23Oh God floor thanks you.
36:24And it seemed to have rolled fast on...
36:25The world �akeful life.
36:26So if you'd be beautiful...
36:28withdrawal if it's too nice.
36:29With my sister
36:33You had finally reworked my Going
36:35I was with
36:40Zoe last night, having her operation.
36:42How did it go?
36:43It went so well.
36:45And in fact, she's probably, yeah,
36:47she's on her way to radiotherapy right now.
36:49That's really good news.
36:50She'll be so thrilled.
36:51So good.
36:56It's good to see you.
36:58Oh, Zoe, you look so good.
37:00Have you seen your face?
37:02No.
37:03Yeah.
37:04Yeah.
37:05You're right here.
37:06Look.
37:11Wow.
37:12So nice.
37:13You look amazing.
37:15It looks so different.
37:17It's like it's not my own face.
37:21It's so beautiful.
37:23It's like it wasn't...
37:25It looks so beautiful.
37:26It's a fun time.
37:27Oh my God.
37:28I am tired of that.
37:30I am tired of that.
37:31That's right.
37:32Oh my God.
37:39If we just did this surgery with no
37:44radiotherapy, there's about a 95% chance that this would just
37:49all come back. However, with the radiotherapy, it lowers that risk to
37:54about 13%.
37:57Radiotherapy is a very
37:59superficial form of x-ray radiation. Now, she didn't have this after
38:04any of her other previous surgeries.
38:06Take a seat on our couch and we'll get you into position.
38:09This works by penetrating into the skin and targets those cells.
38:14They're responsible for making the keloid and it kind of stops them
38:18in their tracks.
38:19Got the lead shielding positioned on her jaw.
38:24How about blocks are made from...
38:29...and lead to protect the rest of the skin so that it's only the scar
38:33tissue that's being targeted.
38:34We know that this is tough.
38:36Yeah, do you want to sit up for a minute?
38:39There's quite a lot to go through after you've just been, you know,
38:43through a seven-hour...
38:44...or operation.
38:45So we're going to do this cheat now.
38:49Okay.
38:54Okay.
38:54So we are all finished.
38:56Okay.
38:57Well done.
39:00How was it?
39:01It was a bit painful but...
39:05I'm happy I've got it done.
39:07So tomorrow I'm going to come back.
39:09...to do the last radiotherapy.
39:11I'm looking forward to seeing a...
39:14...my face without the bandages.
39:16You know, it would be nice to see.
39:19Thank you so much for checking.
39:24You
39:29You
39:34Good morning, Dr. Creighton's office
39:39Good morning, Dr. Creighton's office
39:42Good morning, Dr. Creighton's office
39:44Good morning, Dr. Creighton's office
39:49Good morning, Dr. Creighton's office
39:53Good morning, Dr. Creighton's office
39:59listened to Dr. Creighton's office
40:01I could've seen Michael, Dr. Creighton's office
40:07pandemic
40:10Hi, Zoe!
40:13Hello.
40:14Hi!
40:15Hi, Zoe!
40:15Nice to see you!
40:16My gosh, you look so different.
40:18Come this way!
40:20Look at you.
40:23I mean, what a...
40:25Ah, deference.
40:26I think the smile kind of says it all.
40:29Yeah.
40:31How have things been for you since the operation?
40:34I'm not used to how it looks like.
40:35But I am happy how it looks and don't feel any, like, pain or anything.
40:41It's a big difference.
40:43So this is only three months.
40:45Since the operation, gosh, it's no wonder you haven't got used to it.
40:49Yeah.
40:50Is it okay if I have a look?
40:52Yeah.
40:53Wow.
40:55Wow.
40:55Wow, wow, wow.
41:00It's quite hard to believe that is such a big area.
41:05To have it all excised and just so neat.
41:10And you've got these areas where it's...
41:15a lot paler in colour.
41:17That will all just pigment back up and will match in with the rest.
41:20of the skin and that darkness is from the radiotherapy.
41:24That will fade down.
41:25But this looks absolutely fantastic.
41:30There's no sign of any recurrence at all.
41:33The skin quality itself is much better.
41:35Now, isn't it, whereas before you had the little bits of acne bubbling
41:38that had me worried that any of those...
41:40could become a keloid.
41:41We know now that you have this diagnosis of polycystic ovarian syndrome.
41:45And the medicines that we have you on to control the hormones...
41:51is also controlling these.
41:54It's absolutely perfect.
41:55It's absolutely perfect.
41:56It's absolutely perfect.
42:00Well, this has all gone really well.
42:04It is so...
42:05different to what it was before.
42:07I keep looking at her all the time.
42:10I said, oh, you look different.
42:11You look beautiful, Zoe.
42:13You really do look beautiful, Zoe.
42:15What are the kind of goals you've set yourself?
42:18What kind of nursing would you like to do?
42:20I would like to do dermatology medicine, yeah.
42:23Brilliant.
42:24Yeah.
42:25I think you would be amazing at that.
42:27I do have a lot of confidence that these are...
42:30hopefully not going to come back.
42:32I can't say 100%, but it's certainly...
42:35much more likely to stay away than to come back.
42:40You don't know how much it means what you've done for us.
42:44Just walking in here...
42:45the first time when we didn't have any hope and...
42:50you putting a smile on Zoe's face.
42:55I want to say thank you.
42:58You're going to make me cry.
43:00Aww.
43:01Thank you, Mum.
43:02Can I give you a hug?
43:05I'm so glad you got in touch.
43:09And I'm just...
43:10looking forward to seeing what's going to happen to you now...
43:13over the rest of your...
43:15your life, really.
43:16Yeah.
43:17And the difference that's going to make.
43:19Thank you so much.
43:20Mm-hmm.
43:25She has actually missed out on a lot of...
43:28what we would think of as normal teenagers...
43:30teenage experiences.
43:31And so she's got all of those things to do now.
43:35She would take us off.
43:36Yeah.
43:37And I feel excited for her to do those things.
43:40I wouldn't forget this.
43:41Yeah.
43:42It's our last appointment.
43:43She's got to learn.
43:44Yeah.
43:45It's our last appointment.
43:45And everything.
43:46Now that I don't have the keloids, life will be better.
43:49Let's get into it.
43:50It's our taxi.
43:55Yeah.
43:56Yeah.
43:57Yeah.
43:58Yeah.
43:59Yeah.
44:00Yeah.
44:00Yeah.
44:01Yeah.
44:02Yeah.
44:03Yeah.
44:04Yeah.
44:05Yeah.
44:06Yeah.
44:07Yeah.
44:08Yeah.
44:09Yeah.
44:10Yeah.
44:11Yeah.
44:12Yeah.
44:13Yeah.
44:15Yeah.
44:16Yeah.
44:17Yeah.
44:18Yeah.
44:20Yeah.
44:21Yeah.
44:22Yeah.
44:30Yeah.
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