Baby Girl Born Without a Nose Makes Medical History After Surgeons Create a Custom 3D Implant

When Gráinne and Nathan Evans welcomed their daughter Tessa on Valentine’s Day in 2013, they faced a medical situation they had never imagined.

Their newborn baby had been born without a nose.

Doctors diagnosed Tessa with complete congenital arhinia, an exceptionally rare condition in which the external nose fails to develop during pregnancy.

Her unusual facial appearance was immediately visible, but the greatest concern was something far more serious: how their little girl would breathe safely.

A Rare Diagnosis Before She Was Born

During Gráinne’s 20-week pregnancy scan, doctors noticed that her unborn daughter’s nasal structures appeared abnormal.

Further examinations confirmed serious concerns about her facial development.

When Tessa arrived at the Royal Victoria Hospital in Belfast, she had no external nose or normal nasal passages.

Her condition meant she could not breathe through her nose or experience a sense of smell.

Her First Days Became a Fight to Breathe

Because newborn babies normally rely heavily on nasal breathing, Tessa required immediate specialist care.

At just eight days old, she underwent a tracheostomy, a procedure that created an alternative airway through her neck.

She spent her first five weeks in neonatal intensive care.

Her parents also faced uncertainty surrounding her feeding and future development.

Despite these challenges, Tessa gradually made progress and began experiencing the ordinary joys of childhood.

Doctors Offered a Groundbreaking Solution

When Tessa was seven months old, her parents consulted craniofacial specialists at Great Ormond Street Hospital in London.

They learned that conventional nasal reconstruction would normally involve waiting until she was considerably older.

However, surgeon Jonathan Britto proposed an innovative alternative.

Using three-dimensional imaging and printing technology, doctors could create a personalized implant designed specifically for Tessa’s facial anatomy.

The implant would sit beneath her skin, gradually creating the external shape of a nose as she grew.

A Historic Operation at Just Two Years Old

On May 20, 2015, Tessa underwent her first pioneering nasal implant procedure.

Surgeons inserted a custom-made medical implant through an incision concealed within her scalp.

This approach avoided placing surgical scars directly across her face.

The procedure created a small nasal profile, although the implant was cosmetic and did not restore normal nasal breathing or smell.

For her parents, seeing the results was an emotional milestone.

The Little Girl Who Loved Her New Nose

As Tessa grew, her treatment continued.

In September 2017, she returned to Great Ormond Street Hospital for a larger implant designed to accommodate her developing face.

Her mother later documented additional complications, including skin breakdown around the implant, which required further medical attention.

Although the journey was not without setbacks, Tessa remained an energetic child whose family celebrated her personality and determination.

Her mother recalled the happiness Tessa expressed when she first saw her new nasal profile.

For the Evans family, the greatest achievement was not simply changing their daughter’s appearance. It was helping her grow up with confidence while receiving the specialized care she needed.

Tessa’s story remains a remarkable example of how personalized medical technology can create new possibilities for children born with rare congenital differences.

Sources: Belfast Telegraph, June 4, 2015; Derry Now, October 5, 2017; Gráinne Evans, Tessa: Born Extraordinary.