California: Two-year-old has face re-implanted after dog attack

CALIFORNIA -- A two-year-old girl received unprecedented facial re-implantation surgery at Loma Linda University Children's Hospital after she was attacked by a family dog last August.

The dog had removed a large portion of the girl's face -- from the top of her nose to the top of her lip, including part of her left cheek, according to health officials.

Mariah Salomon was airlifted from a Coachella Valley hospital to LLUCH after the attack. A team of specialists, including otolaryngologists Drs. Nathaniel Peterson and Paul Walker, acted immediately to develop a plan to re-implant Mariah's face, officials said in a news release.

The surgeons said they didn't know if it would be successful, but they knew it was their only chance at giving Mariah a bright future. They were hoping for the best as they risked putting her under anesthesia, despite extensive blood loss caused by the dog bite.

"This was something that had to be completed in a matter of hours," said Dr. Alfred Simental, chair, otolaryngology/head neck surgery.

Officials said the surgery took five hours of intensive work under a surgical microscope, which is unprecedented for a patient so young. Dr. Walker said the size of her facial injury was very unique.

"Given her age and the size of the evulsion of the patient, it was one of the largest evulsion injuries successfully re-implanted on a patient this young," said Walker.

According to Loma Linda officials,  Peterson and Walker worked together to put the arteries back together on each side. They assisted each other, which was key due to the size and difficulty. Post surgery, the team relied on leeches for a week to assist with blood flow until Mariah's veins grew back.

The pediatric intensive care teams were also critical in keeping Mariah alive, keeping her on a ventilator to assist her breathing and replacing her blood volume many times over.

Mariah was able to go home three weeks after the incident.

"We were so lucky," said Mariah's mom, Veronica Peña. "The nurse, doctors, everybody who helped her out - I'm very thankful for everything they did for her. I think Loma Linda University Children's Hospital is the best hospital any parent could ask for."

Aside from some minimal scarring, doctors said Mariah is expected to have a full recovery and be able to have the life she was born to live.

While it's too early to tell if Mariah will get full sensation back, she is already beginning to get some movement back. Her sense of smell is intact, and she can eat and drink whatever she wants, officials said.

"Re-implanting Mariah's facial tissue was probably the most intrinsically rewarding case we have ever done," said Peterson.

The team hopes it will inspire other teams across the country to consider similar interventions.

Mariah's story was shared at the 23rd annual Loma Linda University Children's Hospital Foundation Gala at the Hard Rock Hotel Palm Springs on February 11.

(KESQ - Feb 18, 2016)