American Society of Plastic Surgeons
For Medical Professionals

Actress uses humor to conquer cancer's horror... twice

It was a second cancer diagnosis. This time, Aniela McGuinness knew she wouldn't be able to hide the damage it would do to her body as easily as the first time. There was a real fear this time it would permanently damage her career in front of the camera.

"I didn't know if I'd ever be able to act again because my face was in pieces," said McGuinness.

Since she was small, it was her dream to be on stage.

"I remember as a kid always being amazed when I saw kids' theater or when I would see actors," said McGuinness. "I wanted to do that. I wanted to be there."

McGuinness had a successful career behind the scenes as a props master and then center stage as an actor. She was diagnosed with breast cancer at 31. Three years later, doctors discovered she had an aggressive skin cancer on her nose. They removed the right side of her nose to eliminate it.

"I figured they'd slice, and they'd see that there was nothing there," said McGuinness. "They'd stitch it up, and it would be like no big deal. I really thought that. They did that first cutting, and I'm sitting in the waiting room with a bandage on waiting for them to look at the slides, and they call me back again. They're like, 'We need to cut more.' They cut more and sent me back to the waiting room. They called me a third time, and now I just start crying as we walk back into the room for them to cut more. They ended up going in six times, and they just slowly cut off half of my nose. I remember calling my agent while I was in there going, 'I'm not going to be able to shoot next week because I have half a nose.'"

A rougher reconstruction the second time

This reconstruction was more difficult than her first. She had a double mastectomy after her breast cancer diagnosis.

"I did a one-woman show while I was in the middle of that and used art to cope with it," said McGuinness. "It took several years to heal from all of that, grow my hair back, to feel stable again and healthy and energetic."

Her nose reconstruction was going to be much more obvious because she couldn't cover her face as easily. The surgery interfered not only with her acting but also with a girls' trip to France.

McGuinness asked her doctors if she could leave.

"They're like, 'No, you have a hole in your face,'" said McGuinness. "I'm like, 'Yeah, but can't we just bandage it?' They're like, 'You have a hole in your face.'"

Instead, she took an immediate trip to see plastic surgeon Shashi Kusuma, MD, at Suria Plastic Surgery.

"He stayed open late," said McGuinness. "My husband and I drove straight there for him to look at what had been done. I hadn't even looked at it yet. I didn't want to know yet. He took a look, and he goes, 'The worse it is, the more I like it,' which was shockingly reassuring."

"The right side of her nose, there was no tissue at all," said Kusuma. "You could see right through. The consultation was emotionally difficult because it was a very, very dramatic situation that had happened to her. I think there was a lot of fear percolating perhaps as to how the career would be, how her future would be with this significant defect right in the middle of the face on the nose."

She needed a forehead flap to rebuild her nose. Kusuma would use skin from her forehead above the eyebrows. A large piece of skin was folded down to the nose, while a small section that looked like a bridge of skin attached the forehead to the nose. The bridge was then separated once the nose healed and established its own blood supply. Kusuma compared reconstructing her nose to building a house.

"You have to dig and put a foundation in," said Kusuma. "You have to put the walls up. You have to put the roof, and then you have to do the painting, and you have to do the aesthetics. So, it was exactly the same concept. Reconstructive surgery, cosmetic surgery, plastic surgery is very similar because it's a process that you have to build in stages sometimes. I knew I had to rebuild all of those structures. It was going to be a long process to get to the final stage. Sometimes, this can take six months, eight months, a year, longer. So that is something I had to make sure that she understood."

"What happened to your face?"

McGuinness said the reconstruction process was jarring for others to see during the two months it took until the flap was removed.

"I didn't even want to answer my door at one point," said McGuinness. "I answered the door for a delivery person, and they just stared at me. They were like, 'What happened to your face?' So, I didn't even want to go out."

Other's reactions to her cancer this time were very different from when she had breast cancer.

"When I had breast cancer, it was kind of like a parade wherever I went," said McGuinness. "People would come up and be like, 'You can do this. You've got this.' When I had this [nose reconstruction], I found people wouldn't look at me or they would stare."

Yet, McGuinness was not going to let reconstruction disrupt her acting. She continued rehearsals for The Vagina Monologues.

"It was a few days after we finally removed the flap that I performed on stage, which was so odd," said McGuinness.

Sprouting a nose ponytail

Her nose was rebuilt but she still was not completely satisfied with the result.

"We had finished four surgeries, but it was still knobby," said McGuinness. "You could still tell that something happened. He [Kusuma] asked me, so humbly, 'What don't you like about it?' I was like, 'This is a little thick up here.' So we repeatedly would meet every month or so and he would numb the area and slowly just chisel away at it. Again, he would be like, 'What don't you like?' I'm like, 'Well, this spot,' and he'd go in and just keep tweaking."

McGuinness also found her new nose came with some unexpected upkeep.

"It's my scalp inside of my nose, so I can grow a ponytail out of my nose," said McGuinness. "I remember telling him I'm having a hard time breathing, there's so much hair in there. He, for free, had them do electrolysis on my nose. We tried to get out as much hair as possible. I may still have to trim it because I can still grow a ponytail."

Something marvelous happens

Less than a year later, McGuinness was hired for a role on the hit Amazon Prime series The Marvelous Mrs. Maisel.

"Now I'm able to act again and model," said McGuinness. "So, from being a kid and wanting to model, I can still do that."

"I'll never forget it for the rest of my life," said Kusuma. "If there is a person that makes an impression, it's Aniela. She actually did glamour shots during the healing process while she was going through it. That's how she made something very traumatic into something very, very creative. She never lost her mojo for being an actress, an improv artist, model. She incorporated all of that through the healing process."

Don't be that person

Strong family support, surviving breast cancer and a solid sense of humor helped her to recover.

"The most important thing I felt about her is that she had a very positive attitude, and she was very motivated to do whatever it takes to get it as right as possible, as close to normal as possible," said Kusuma.

Yet, McGuinness said there were times she struggled, and she learned to accept the sadness.

"You don't have to be positive to get through it," said McGuinness. "You still get through it, and you can be sad because that is also true. That was where a lot of strength came in. It was learning to feel all of it and work through it and let myself be really angry and really sad and scared."

She asks others to be more empathic towards those with facial differences.

"Going through facial reconstruction is hard enough, but the fact that you have to go out in public and deal with other human begins can be really, really tough," said McGuinness. "If you are somebody who sees somebody who has something different about their face, don't ask them what happened. It's just not helpful. I think the biggest key is to treat them normally, smile, be nice, compliment their hat, treat them like you would anybody else."

She said those who were kind to her made the biggest impression on her.

"In the grocery store, somebody just said, 'I wish you the best with what you're going through,' which I thought was just really nice because they acknowledged it, which they didn't have to," said McGuinness.

As if it never happened

McGuinness said working with Kusuma was life-changing because he made sure cancer didn't alter her life at all in the long run.

"How my life has changed from working with Kusuma is mainly that it didn't," said McGuinness. "It's as if it never happened, and that's a miracle in itself. It will get better. It might look terrible, but they can do amazing things."

What you see today is a testament to all of the effort they put in together as surgeon and patient.

"She was a patient that I knew I could work with and make a real difference in her life," said Kusuma. "It required a lot of technical skill. It required a lot of creative thought process. It required a very thoughtfully managed process over a long period of time."

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.


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