Charlotte Ponce is hoping this surgery will mean she can finally wear earrings.
The 14-year-old from Spring Lake was back at Beaumont Hospital in Royal Oak on Thursday, years after a raccoon mauled her face when she was a baby.
She has had more than a dozen reconstructive surgeries since then.
This one, her first as a teenager and the eighth at the hands of pediatric plastic surgeon Dr. Kongkrit Chaiyasate, involved adding additional tissue to her ear, cheek, nose and upper lip.
"Now, it’s just working on tweaking everything, making everything better," said Sharon Ponce, Charlotte's mom.
Charlotte was 3 months old when a pet raccoon crawled into her crib and ate away her face from her nose back to her right ear. Ponce thinks the raccoon was attracted by milk that had spilled on her face from the bottle that was left propped in her mouth.
"It's a miracle that she survived," Ponce said.
Ponce, 57, and her husband, Timothy, 66, a retired factory worker, gained custody of Charlotte and her older bother shortly after the incident. Their biological parents' rights were terminated.
Since then, a whirl of surgeries and doctors' appointments has been a part of life for the soft-spoken girl who loves animals and swimming.
In one of Charlotte's most intricate surgeries in 2014, Chaiyasate took cartilage from around her ribs and molded it into a "C" shape. He then placed it under the skin of her right forearm, where it "grew" for about three months — with additional tissue forming around it — before it was removed and attached to her head, replacing the ear destroyed by the raccoon.
Growing an ear on a forearm is a rare procedure — Chaiyasate said it has been done fewer than five times.
Prior to that, the surgeon already had built Charlotte a new nose using skin from elsewhere on her body and rib cartilage. Her upper lip was reconstructed.
"She's a fighter," Chaiyasate said. "She's never cried. With every surgery, she's never complained."
On Thursday morning, Charlotte sat calmly in a hospital waiting room holding two stuffed animals and a colorful quilt she takes to every operation.
"I'm used to it by now," she said the previous night. "I've been having surgeries since I was about 3 months old."
Chaiyasate took tissue from Charlotte's stomach and put it behind her right ear to make the ear more projected. Stomach tissue was added to her upper lip to give it more fullness.
He also took a small piece of tissue from her left ear to enlarge one nostril, used fat from her stomach to make her right cheek fuller and performed scar revision on her lips.
The procedure lasted about 90 minutes.
Insurance covers the cost of the surgeries.
Charlotte has made considerable progress since becoming Chaiyasate's patient in 2012. The doctor even won the 2014 Best Microsurgical Case of the Year presented by the American Society for Reconstructive Microsurgery for his work on her.
"He's like an artist," Ponce said.
But the transformation has been more than just physical.
Chaiyasate said Charlotte has become more outgoing with him; at first, she avoided making eye contact.
She's lost the fear of doctors she had when she was younger. And she no longer worries about participating in physical activities, like gymnastics, because of a fear that she could hurt her face.
"She was a little girl when she had her last surgery," Ponce said, "and now she’s a young lady."
Charlotte and her parents drove Wednesday to a motel in Madison Heights, about three hours from their home in Spring Lake, to stay the night before the surgery.
Charlotte wore pretty purplish lipstick and some of her long hair draped over the right side of her face.
Socializing is often difficult for her Charlotte, who just finished seventh grade. She struggles with depression and has a small group of friends who view themselves as the outcasts at school.
Charlotte eventually wants to become a biomedical engineer, building prosthetic devices for people.
In the years after the attack, hundreds of cards and many gifts came flooding in from well-wishers. Reporters followed her to nearly every surgery.
Today, much of the attention has quieted down.
Chaiyasate said Charlotte's long-term prognosis is excellent. She could chose to have future procedures, but it would likely just be for fine-tuning.
Ponce keeps people who are interested in her daughter's story updated through the Facebook page "Friends of Charlotte Rose."
She said Charlotte has inspired people she's never met.
"She's gotten all kinds of letters," she said. "People said they look at the courage she has, and it gives them courage."
Charlotte has been eager to wear earrings. During surgery in 2014, Chaiyasate used a tiny piece of tubing to fashion an earring in her right earlobe. However, the tissue around the hole eventually tore.
Chaiyasate said after Charlotte heals from this latest surgery, she should be able to get the ear pierced.
She has about 50 pairs of earrings waiting at home.
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