Hang onto that belly fat, it may come in useful! In a UK first, surgeons at King's College Hospital in London, have taken fat from a man's stomach and injected it into his head to help reshape it. The patient had had some of his skull removed, and surgery to reconstruct a shattered eye socket, cheekbone, and leg, following injuries sustained when he fell while climbing up a drainpipe outside his house. The patient is Tim Barter, a visual effects supervisor on the Dr Who television series. In June 2009, Barter, then 32, fell 25 ft (over 7.5 m) off a drainpipe onto a brick wall as he tried to gain entry into his house in Brixton, through an upstairs window. He had lost his keys the night before on a night out. His neighbours found him a short while later, and he was taken by ambulance to the Major Trauma Centre at King's College Hospital. Barter was in a coma for 10 days. When he woke up, he discovered he had a brain haemorrhage, a shattered eye socket, cheekbone, and a broken leg. Barter says he does not remember the fall at all. He says he probably broke his leg when he fell onto a brick wall that temporarily broke his fall, and then must have landed on his face after he carried on falling. Rob Bentley, a Craniofacial Surgeon at King's, told Barter that to ease the swelling in his brain from the haemorrhage, they had removed part of his skull. Barter learned that he would also need further surgery to reconstruct his cheekbone, eye socket and leg. In a statement released from King's this week, he says: "My head felt really strange. I only had skin over where the skull had been removed so it was very soft to touch, particularly when the hair had started to grow back." Barter was in hospital for several weeks, while he had titanium plates fitted to shape his shattered eye socket and hold the bone together. These were inserted through his mouth so as not to leave scars on his face. He then went home, but couldn't go outside much: doctors told him to stay indoors to rest and repair. Barter was worried that he would not be able to work again. "Life stopped for a number of months. I couldn't work and I had double vision. I was frightened that my eyesight would never go back to normal and that I would have to give up my job for good," he said. Eventually, in December 2009, some six months after his fall, surgeons at King's fitted a titanium plate to replace the removed piece of skull in Barter's head. Up until having the plate fitted, simple things like going to the toilet gave him intense headaches, explained Barter, "Bending down to do anything was agony," he said. Experts at King's had made the plate from a mirror image of the other side of Barter's skull, modelled using computer technology. Bentley, who is also Director of Trauma, said: "Tim came to us with significant head and facial injuries and was treated here both in the initial phases and also for his secondary reconstruction." He explained that Barter's case highlights an area of expertise that he has developed at King's over the last nine years, during which time they have inserted over 250 such prostheses with the lowest infection rates in the world. Later, the surgeons then also took fat from Barter's stomach and injected it into his temple to fill a hole that had appeared when some inactive muscle collapsed. This is the first time a patient has undergone such a procedure in the UK. Bentley and his team at King's developed the new and unique cosmetic technique to restore the face after injury. Since the surgery, Barter has completely changed his life. He is keeping fit (he sees a personal trainer four times a week), is improving his diet (he has consulted a nutritionist), has had his teeth reconstructed and his eyes lasered so he does not have to wear glasses. And the trauma of the fall has not put him off heights: if anything it has given him a love of tough sports, including sky-diving, rock climbing, fencing and kayaking. He says he is now "simply making the most of everything" and even loves the sensation of falling in the extreme sports he is practising, and jokes that the "split second" at the end is only "an occasional problem". Bentley and his patient Barter, will be talking about the methods used at King's to repair Barter's injuries on BBC Breakfast at 08:10 am on Thursday 1 March.
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