Clifford Llewell hides a large hole in his face behind a mask so he doesn't frighten children.
But one day soon, he will be able to smile again thanks to a skilled surgical and technical team and a face that clicks on like a magnet.
The 76-year-old has no teeth or nose, his upper lip is gone along with his upper jaw after having a large tumour removed. The cancer, nasomaxillary carcinoma, has spread too deep for any further surgical removal and it is not known how much longer Mr Llewell has left.
But the softly spoken pensioner still counts himself as one of the lucky ones and lights up when he talks about his new face.
The surgical and technical maxillofacial teams at Waikato Hospital are working together to rebuild his face.
For Mr Llewell, it will mean he will be able to live out his last days without having to hide his face in public.
"I like to wear my mask everywhere because otherwise kids get frightened and I don't want to frighten them."
Mr Llewell said it had been a big hurdle.
"When I first went up, they diagnosed me with cancer on the top lip. I had to have surgery to take it out. I had to have seven weeks of radiation and chemo. I came home thinking it was all clear."
But Mr Llewell soon noticed a little sore inside his nose and went back to the hospital. He has now had three surgeries - each time cutting more away from his face.
He said the doctors didn't know exactly what caused his cancer, however he was a smoker for a number of years before he quit three years ago.
"Last week, when we went up, my son said 'how long do you think he's got doc?' to the specialist and he said 'well we can't predict that, you could be here for 12 months, we don't know'," he said.
"They can't operate anymore because they are getting too close to the brain."
Mr Llewell said it was "amazing" to have a team building him a new face.
"They are going to put studs [implants], like magnets in my face and my new face will just click on like a magnet. They say I will look better than what I do now," he laughed.
Mr Llewell said the surgical team have tried everything to try and cure him. "All the doctors have been lovely and the nurses are marvellous, it's amazing stuff they do . . . There is a lot of work involved."
The humble man believed there were a lot of people worse off than he was after what he saw in hospital.
"I was lucky compared with some of those poor people in there. I still count myself lucky."
Mr Llewell said eating and drinking were now a problem. "If it's mashed up I can get it down . . . When I get my new face they reckon I'll even have new teeth. They were the first things to go because you can't have radiation with teeth.
"Every time I see someone eat a hamburger I just drool at the mouth. I reckon that will be the first thing I have. I'm hoping that will happen," he said.
"When they said they couldn't do anymore, I thought well it's just a matter of time, so I went down and ordered me a coffin."
He said he went to the Rotorua Coffin Club and they charged $260 for a coffin that he gets to decorate. "There's a guy that's going to paint it up for me. My son has all sorts of ideas ... My son has been marvellous."
"It was quite funny when we went down (to the coffin club). There were two ladies making the lining for one of the coffins and I lifted up one leg to try and get in and they said 'No not yet! Not yet! You're too early'!"
He said he already had a headstone and he would be buried with his wife.
"I lost my daughter and my wife to cancer, so I think it must be just my turn ... my granddaughter has breast cancer too," Mr Llewell said as he looked around his living room filled with family photos.
Mr Llewell was born and raised in Rotorua. He attended Ngongotaha Primary School, but at the age of 14 his father was killed in a motorbike accident, forcing him to drop out of school and run the family farm. He did that for three years before he went to work for Fletchers in Ngongotaha for 26 years.
"Then they passed everyone letters saying our services were no longer required and I got a job with Placemakers. I worked for them for 14 years."
He then brought a commercial cleaning business which he ran before retiring.
Mr Llewell's maxillofacial clinical technician, Mike Williams, said he thought the way they were proposing to rehabilitate his patient would be a first for New Zealand.
"It's a bit more than a normal denture situation. I'm pretty sure using the implants we are looking at using and the fact that such a big chunk of his mouth is gone as well as the front of his face, this will be a first in New Zealand.
"I'll be doing a lot of the work, both clinical and technical, but it has to be a team approach, there's no other way of doing it.
"What we are hoping, with the implants we are looking at placing, it will mean the denture can click on and will allow him to be able to chew properly again. Implants are so you can restore normal biting force, the forces get redirected back through the facial skeleton, because at the moment all the pressure will be just on his residual gums at the back."
Mr Williams said all Mr Llewell had left was two little bones at the back of his checks,
leaving a big hole and all the bone that was normally used to support the denture was gone.
"The implants are about 45 to 50mm long in his cheek bones and if we can we may place dental implants, they are really small.
"We need to work out if we are going to use a bar frame work or magnetic components. It could be a combination of both. He will be able to take his nose off and stick it to the fridge." Mr Williams said the problem with magnets was they could pivot, but with a bar framework it would stay in one place.
"It's not just about restoring his appearance, it's about restoring his function."
He said the prosthesis would be made out of platinum cured silicon.
"There's two steps to it, we have to do the dental rehab before we do the facial prosthesis rehab because the dentures are the underlying supporting structure, and that determines where his nose and lip should be positioned.
"The good thing is because we got the pre-operative cast we have a very good idea of what his anatomy used to be like before his surgery, so that will guide us in terms of designing the denture, to obviously restore his smile and from a functional standpoint it
gives him something to bite and chew against.
"He should be able to eat better once we have the dental rehab done. Once that's done the rest of it should be straightforward."
Mr Williams said as soon as Mr Llewell's facial tissue had healed, because he was still fairly fresh from the last surgery, the surgical team would be able to make their next move.
"But I will be working closely with them to place and secure the implants. Normally you wait around three months.
"In the interim we will do what we can with normal techniques, he has a new surgical base plate which we just fitted last week with a new liner on top, once that's healed we can
make him something that looks a lot better than what he has presently got.
"The stuff he has at the moment is called tissue conditioner, so it's nice and soft but it's only a short-term solution while things heal, once everything is settled down nicely we can go into definitive long-term materials and then just crack on and get the denture made.
"So hopefully within four to six weeks we should have that sorted. "I'm going to have to get some advice from colleagues overseas to find out the best way of treating him because things like this have happened in the UK and other places, but not New Zealand.
"We have had other patients with similar types of cancer and it does tend to be fairly slow in terms of how it progresses and Clifford is fit and motivated and he's come through everything really well considering.
"He is the kind of patient you want because I know he will give us a lot of feedback in terms of what we are actually doing and it's good when you have patients that do that, particularly with the facial prosthetics because at the end of the day they are the ones that are wearing it. It's their face."
"It's quite likely we will end up taking an impression of his son and we will give him his upper lip and his nose, unless of course he wants somebody else's, if he wants to look like Hugh Jackman we can make him look like that if he likes. "He has full creative control over what he's going to get."
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