Woman praises 'hero' surgeons who saved her smile

A woman who had pioneering surgery to remove a tumour has described her surgeons as "heroes" after they avoided facial paralysis and managed to save her smile.

Suzy Spence, from Carrickfergus in County Antrim, was diagnosed with a tumour in her salivary gland in December 2023 and was warned that a cancer diagnosis could not be ruled out.

As the facial nerve was wrapped round the tumour, the 28-year-old was warned surgery could cause partial facial paralysis, which could prevent her from being able to smile.

While general surgery was available in Belfast, her family found specialists in London who used a radical technique involving an MRI scan and a hologram.

That provided surgeons with more accurate positioning of the nerve and tumour, which meant they could operate with greater precision and confidence that her face would remain unchanged and her smile would be saved.

According to the surgeons, the radical technique is "breaking taboos" in the world of surgery.

PR consultant Ms Spence first felt a lump behind her ear in September 2023 when she was putting in an earring.

After several visits to her GP and dentist she was referred to her local hospital for an ultrasound and she was red-flagged as needing urgent care.

With a risk of cancer, the family paid privately for an MRI scan which confirmed a tumour.

"There was the risk of cancer and there was also the risk of severe or temporary facial paralysis - it was very scary," Ms Spence said.

She was told she required parotidectomy surgery which involved removing part of a major salivary gland in her cheek called the parotid gland.

The positioning of the parotid gland was important as it was preventing the tumour from damaging facial tissue or harming important nearby structures, including the facial nerve.

While general surgeons could have performed the surgery in the Belfast Health Trust, Ms Spence's family found a specialist oral and neck cancer surgical team from University College London.

They offered pioneering treatment that used a high-tech MRI scan which produced a hologram that identified the exact position of the tumour and the facial nerve before the surgery.

Axel Sahler Sahkhofeler, a consultant head and neck surgeon who operated on Ms Spence, said the "minimalist invasive approach" was rare and practiced by only a few surgeons.

Mr Sahkhofeler said the procedure had several benefits, including lowering the risk of facial nerve weakness and lowering the risk of the patient developing Frey's syndrome, a rare neurological disorder which can cause a person's face to sweat when they should be salivating.

It also causes less disruption to the shape of the face.

The surgery took place in London in January 2024.

Hours after the operation, Ms Spence's mum, Margie Butten, visited her daughter and was relieved to see her sitting up in bed and smiling.

"She was in surgery for some hours; my other daughter and I just wandered around London waiting for the call, we were so worried," she said.

"Then we got the phone call to say she was out of surgery and to see her sitting up in bed with such a beautiful smile, such a beautiful girl - it had all been worth it, " Ms Butten said.

The MRI scan and the 3D model provide surgeons with greater accuracy as to where exactly the tumour is going to be in relation to the facial nerve; it also means they can establish a surgical plan before going into theatre.

Mr Sahkhofeler said there was a small risk to one of the branches of the facial nerve, but knowing this beforehand and being able to plan around it meant the operation was smoother.

Given the risks of the surgery, Ms Spence was immediately anxious to see if there were any side effects once she woke up.

"I woke up from my surgery and was desperate to see a mirror to see if I could smile. I kept feeling around my mouth; I thought I could - and a mirror confirmed I could - still smile, I was so happy," she said.

"My surgeons said they couldn't believe I was still able to smile; everyone was relieved and happy."

A week after the surgery, a biopsy confirmed the tumour was benign.

One year on, Suzy is still smiling.

Ms Spence said the experience had made her realise how "fragile life is".

"I was so lucky that my family found the surgeons and that I was able to go to London," she said.

"Being able to smile is one of those things you don't really think about until you think that it suddenly might be taken away from you and at such a young age. I was just scared of losing that."

The family has not revealed the cost of the private operation, which involved flights and hotel accommodation, but Ms Butten said there were no regrets and that it was "money well spent".

"While we had the money, to be honest, if we hadn't, I think I would have remortgaged the house," she said.

"At that age, to have been left in that position, it would have been life-changing."