For almost a year, Chanel de Wet has been unable to smile or close her right eye - even while sleeping - after surgery to remove a tumour left the right side of her face paralysed.
But after a ground-breaking "reanimation" nerve transplant in Cape Town on Thursday, the 21-year-old accounts clerk hopes that within six months she will be able to face the world with confidence again.
"Not being able to show emotion does get you down," she said. "A face is something you can't hide … it's your profile. I will be grateful if I can at least smile again someday."
The Johannesburg woman lost sensation in her face after a nerve was damaged last November during surgery to remove a schwannoma, a tumour of the nerve sheath.
The paralysis not only damaged her self-esteem but affected her quality of life, leaving her struggling to eat, drink and sleep.
"In the beginning I lost all my confidence. I shied away from taking pictures as I struggled to come to terms with everything that happened," she said.
Surgeons who operated on De Wet at Louis Leipoldt Mediclinic in Cape Town were cautiously optimistic after harvesting a nerve from her leg and connecting it to her face.
"The surgery went well but was technically challenging due to fibrosis from previous surgery and the small size of the nerve branches in the face," plastic surgeon Professor Frank Graewe said on Friday.
Graewe and two colleagues involved in the seven-hour procedure hope the transplanted nerve will grow and restore five branches of the facial nerve, including the buccal and zygomatic branches, which will allow De Wet to smile again.
Success means she will have control of her lips, gain eyebrow movement and be able to close her right eye.
Graewe, who teamed up with head and neck surgeon Justus Apffelstaedt and ear, nose and throat surgeon Professor Louis Hofmeyr, said until now patients such as De Wet had to seek treatment overseas.
"Not many doctors in SA endeavoured to do [this procedure] due to its complexity," he said.
"Microsurgery is also very stressful, with hours spent on the microscope."
De Wet's recovery is expected to take between six months and a year.
Her mother, Chantal, said even though they were told by many doctors and specialists that her eldest child's face would be paralysed permanently, she never lost hope.
"It's difficult for a mother to see her child going through these depressive episodes. I remain very positive that everything will go well," she said.
De Wet said that even if she did not regain full facial movement she desperately wanted to be able to smile again.
"Sleeping is a bit problematic for me as I can't close my eye … which eventually gets very dry. But not being able to smile is worse. As long as I can get my smile back I will be OK."..