American Society of Plastic Surgeons
For Medical Professionals

The remarkable journey to build a nose

Harrison "Gray" Canales had a typical childhood but an atypical life. His early years were interspersed with numerous surgeries because he was born with a severe bilateral congenital deformity. The face staring back at you today is a testament to his journey, resilience, personal growth and the remarkable medical achievements that shaped his life.

His parents knew 20 weeks into the pregnancy, after a sonogram, that their baby would face complicated medical issues. It was a difficult diagnosis to grapple with as they expected their firstborn.

"The doctor said the baby is coming with many problems and, actually, he couldn't really say whether he would be able to survive," said Mary Jo Canales, his mother. "So, the rest of the pregnancy, it was really difficult to deal with that. Am I... are we going to get to hold our baby or not?"

John Canales, his father, still remembers Gray's birth vividly: "There he was, this little, tiny guy who fit on my forearm. And I looked at him, and he was just the most beautiful little thing in the world."

Born without a nose

A bilateral congenital deformity is a physical abnormality on both sides (bilateral) of the body and is evident at birth (congenital). For Canales, this meant he was born without a nose.

"I always thought Gray was our special gift from God," his mom said. "I would say in Spanish he is 'mi tesoro, my treasure, my little treasure.' He still is."

His facial difference never made Canales feel he was different from others. His family and the medical community stood unwaveringly by his side.

"It just was something that I grew up with, that I had when I was born, basically," said Canales.

Not defined by his condition

Despite his challenges, Canales never let his condition define him. He said he maintained a tight-knit group of friends who "accepted me for who I was."

James Thornton, MD, one of Canales's plastic surgeons, struggled with the decision to take Canales's case because of its complexity.

"In terms of the difficulty of his nasal reconstruction, it was essentially as hard as we've done," said Thornton.

The process required a total nasal reconstruction. Essentially, the surgeons had to create a nose for Canales. Yet, the challenges did not dampen the spirits of the dedicated medical team or Canales. Jessica May, MD, another surgeon on Canales's medical team, recalled their first meeting when he was wearing a Star Trek mask. The rapport they shared was immediate.

"Of course, I asked him if he liked Captain Kirk or Captain Picard more," said May. "To which he very smartly responded, 'Very tough question. I don't know because they are both great.'"

Getting to choose his nose

Canales got to pick his nose and spent hours searching through pictures to find the perfect fit for his face. His choice was both touching and endearing. Canales picked a nose resembling his paternal grandfather's, a man he had never met but had heard countless heartwarming stories about.

May chuckled as she said, "But then he said in a follow-up email that Chris Pratt would be great if we can work that in too."

Despite the numerous surgeries and setbacks, Canales's optimism shines through, a trait both his surgeons admire.

"Spend some time with him today. You'll see what a remarkable kid he is," said Thornton, emphasizing that through all the bumps, Canales never complained once.

Canales looks to the future with hope as he adjusts to his new look.

"Wow, it's different," said Canales. "It's big and different. I've just been happy with what I look like. Having a new nose, it's great to have now."

He acknowledges that some people might have looked at him differently before.

"It might affect getting a job a little bit, so hopefully, now that this is all complete, that'll help me a little bit," said Canales.

A story of resilience and modern medicine

Canales's journey isn't just about his growth. He actively gives back to the community, mentoring children with craniofacial differences and volunteering at his church.

"I want to share what my experiences are. I want people to know what I've gone through," said Canales. "Be happy with the way you are, and Jesus loves you just the way you are. And that's the most important thing."

Canales's story underscores the power of resilience, the capabilities of modern medicine and the profound impact of personal growth. It serves as an inspiration to face challenges head-on, to never lose hope and, most importantly, to embrace and love yourself.

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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