Tessa Evans was born in Northern Ireland with complete congenital arhinia, an extraordinarily rare condition in which the nose, nasal pᴀssages and sense of smell do not develop. Her condition also meant doctors had to carefully manage her airway from the very beginning.

At just eight days old, Tessa underwent a tracheostomy to provide an additional airway and allow her to breathe and feed more safely. Her first weeks were difficult, but her family soon saw something that had nothing to do with her medical diagnosis: Tessa was a cheerful, energetic child who loved to play and laugh.

Then, when Tessa was two, her case entered medical history.

Surgeons at Great Ormond Street Hospital used CT imaging, 3D modelling and rapid-prototyping technology to create a custom-made implant designed specifically for her face. The implant was placed beneath the skin and gradually expanded the surrounding tissue, creating a foundation for later reconstruction as she grew.

The approach was groundbreaking because traditional reconstruction generally had to wait until much later in childhood or adolescence. Tessa’s treatment offered a way to gradually shape the tissues while she was still growing, giving her a more age-appropriate facial profile along the way.

Her mother, Gráinne, has also spoken openly about the fear and uncertainty surrounding Tessa’s birth. But as the years pᴀssed, those fears were replaced by admiration for the little girl who refused to let an extraordinarily rare condition define her personality.

Tessa’s story ultimately became about much more than the absence of a nose. Her case helped demonstrate how modern 3D technology could be adapted for an exceptionally rare reconstructive challenge — while her family used their experience to raise awareness and connect with others facing similar conditions.

Tessa didn’t need to become “ordinary” to show the world how extraordinary she was. ❤️✨

SOURCES:

• Great Ormond Street Hospital/UCL medical case report