King's Craniofacial Surgeon, Rob Bentley and patient Tim Barter appeared on BBC Breakfast, Channel 5 news and BBC News to discuss these innovative and unique techniques, which were used here at the hospital.
In June 2009, 32 year old Tim Barter from Brixton found himself locked out of his house after losing his keys on a night out. Unable to get hold of a house mate, he decided to climb the drainpipe, to gain entry via an upstairs window and fell around 25ft, his fall broken temporarily by a brick wall.
“I have absolutely no recollection of the fall. I presume that as I fell, I hit the wall with my leg and as that broke, I carried on falling and before landing on the floor face-first,” Tim says.
He was discovered unconscious a short time later by his neighbours and an ambulance took him to the Major Trauma Centre at King’s College Hospital. Ten days later, he woke from a coma with a brain haemorrhage, a shattered eye socket and broken leg.
When Tim awoke, Mr Bentley broke the news that in order to cope with the bleed and swelling on his brain, part of the right hand side of his skull had been removed. Tim also heard that he needed further operations to reconstruct his cheekbone, eye socket and leg.
“My head felt really strange. I only had skin over where the skull had been removed so it was very soft to touch, particularly when the hair had started to grow back,” says Tim.
Tim stayed in hospital for a number of weeks, during which time titanium plates were used to fix his shattered eye socket, shape the socket and keep the bone together. To cause minimal scarring these were inserted via the inside cheek of Tim's mouth.
He was able to go home but urged to remain in doors as much as possible to rest and repair.
Finally in December a custom made titanium plate was made and fixed in place, to replace the piece of removed skull. This was developed at King’s using computer technology which creates the shape of the titanium plate by mirroring the other side of the skull.
A UK first
In the summer of 2011, Tim was the first person in the UK to have fat taken from his stomach which was then injected into his temple, to fill out a concavity that had appeared as a result of the slump of inactive muscle. This is an innovative and unique technique that has been developed by Mr Bentley, to cosmetically improve the outcome of facial injuries.
Tim has previously worked as a visual effects supervisor on the set of Dr Who, for three series. Within that role he advised on the filming of visual effects on set and then post-filming he also put together the digital shots by combining the real footage with the visual effects. A huge Dr Who fan himself, Tim feared that his accident would prevent him from working on Dr Who again.
“Life stopped for a number of months. I couldn’t work and I had double vision. I was frightened that my eyesight would never go back to normal and that I would have to give up my job for good. Up until I had the titanium plate fitted, simple things like going to the toilet caused intense headaches. Bending down to do anything was agony,” Tim added.
Mr Bentley, who is also Director of Trauma, says: “Tim came to us with significant head and facial injuries and was treated here both in the initial phases and also for his secondary reconstruction. Tim highlights an area of expertise that I've developed here at King's over the last nine years, in which we have inserted over 250 such prostheses with the lowest infection rates in the world. In addition, patients having sustained such injuries as Tim's highlight the fully integrated approach that we have as a Major Trauma Centre. This ensures that our patients receive the best treatment in the most appropriate settings and by the most appropriate individuals."
Making the most of everything
Since the accident, Tim has turned around his life. He sees a personal trainer four times per week, has sought advice from a nutritionist, had his teeth rebuilt and his eyes lasered. Ironically, he has no fear of heights and has started rock climbing, kayaking, fencing and independent sky-diving.
"I'm simply making the most of everything now where I didn't before."
Asked about his new love of extreme sports and whether he’s had enough of falling, Tim jokes: "I love the falling! It’s just the split second at the end that’s an occasional problem!”