When I first met Mary, already in her forties, she had suffered throughout her life from an arteriovenous malformation of the face. As a result, from early childhood, she had endured the discomfort and humiliation that accompanies the stares of strangers. She came to me hoping I could improve her appearance.
The abnormal connection between the arterial and venous halves of her circulatory system caused her cheek, jaw, and neck to be constantly swollen and red, pulsing with every beat of her heart. Normally, the pressure of the pulse is dissipated as the arterial vessels narrow, and the blood flows through the very small capillaries. By the time the blood enters the venous side, the flow is smooth, more like the surface of a lake, but for Mary, the effect was more akin to the pounding of the surf on a beach during a major storm.
Mary had tried everything in her power to hide the disfiguring facial deformity, from makeup to surgery, but her efforts were to no avail. By the time we met, she had undergone more than two dozen surgeries, yet her deformity remained highly visible.
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