University of California San Francisco

UCSF Magazine
January 22, 2024

Shortly after Alexander Lin, MD, joined UCSF Benioff Children’s Hospitals in 2022, a 12-year-old boy was flown in for emergency surgery. The child had been run over by a vehicle, and nearly every bone in his face was shattered.

As co-director of UC San Francisco’s Craniofacial Center, Lin was the lead plastic surgeon on the case. He had his work cut out for him. The child had suffered severe fractures to his eye sockets, cheeks, nose, and jaws. His eyebrows and lips were torn apart. His forehead bone – which surgeons elsewhere had removed when his brain began to swell – would need to be reconstructed entirely. He’d also lost vision in his left eye, and ophthalmologists suspected that one of his optic nerves had been injured. The vision loss could be permanent.

“It was a difficult, difficult case,” Lin says. “Reconstructing this child’s face bones would be like fixing a broken egg that’s covered by a blanket. I can’t just cut open his skin to see the fractures and fix them. I have to make little hidden incisions under his eyelids, mouth, and lips. I’m basically making holes in the blanket and then trying to fix the egg through the holes.”