Karnee Bishnoi, 38, remembers a bull charging at him, coming right at his face. His next memory is waking up at a Delhi hospital 4 days later. And 11 months and several surgeries later, he has a near-normal new face.
“It feels like a rebirth,” the employee of an FMCG company told TOI. On September 3, 2020, Bishnoi and his friend were home in Bikaner when they slowed down to let two bulls pass. “But suddenly, one of the bulls turned back and charged at me, hooking its left horn in my face,” Bishnoi told the daily.
The bull’s left horn lacerated his lips, crushed his nose, gouged out the right eyeball and herniated upward through the front lobe of his brain, the reports adds. He was rushed to a nearby hospital but had to be shifted to a Delhi hospital.
Bishnoi's office made arrangements for him to be airlifted to Delhi on September 5. A team of doctors at Max, Saket at, led by plastic surgeon Dr Sunil Choudhary and neurosurgeon Dr Bipin Walia started treating him.
A series of medical procedures and surgeries followed, including the damaged portion of brain being sucked out, brain's membrane repaired, rib cartilage and thigh connective tissue being used to reconstruct the face.
With a portion of Bishnoi’s skull missing, it was imperative to provide the brain a bone cover. “Normally, we would use a titanium mesh as a patch. But in this case, we didn’t have enough time to get a customised implant of the dimensions required,” said Choudhary, the report adds.
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The doctors had to take a part of his remaining skull and split it into two layers, putting the inner layer back in its regular place and using the outer layer to patch up the defect. Bishnoi’s nose and lips were crushed into 20 and six parts, respectively. The plastic surgery team pieced them together while ensuring blood supply for tissue survival. This surgery lasted almost nine hours.
It took Bishnoi around a week to gradually regain his memory, speech and mobility. “The only explanation for the neurological recovery despite such an injury was that the damage to the brain was limited to the right frontal lobe, whose functions are still not fully known,” Choudhary told TOI.
His face reconstruction was another important chapter. The nose was sculpted from a rib cartilage. The right side of the face was reconstructed using the thin casing of connective tissue surrounding the thigh to connect to his temporalis muscle in a technique developed by Choudhary.
The volume loss on the face was made up by using fat harvested from Bishnoi’s abdomen. These procedures took nearly 10 hours. The doctors' effort to put an artificial eye in the right orbital cavity didn't work initially as the eyelid was not functional.
After the second surgery, Bishnoi was advised to practise mirror biofeedback to move the forehead on the affected side in front of the mirror. Bishnoi spent hours doing this and after four months of practice, one day he felt that his right forehead moved a little “It was my eureka moment. From then on, I worked harder and there is now significant movement,” he said..
Doctors now plan to connect Bishnoi's eyelid to his forehead so that the eyelid movement could be restored. Then an artificial eyeball will be placed in the orbital socket. After that the face restoration will be complete.