Page A16 December 2022 FUNERAL HOME & CEMETERY NEWS Se c t i on A Last month I touched on the treatment protocol necessary to create a dry, firm base on which we would begin any type of soft tissue-reconstructive work. This holds true whether it is on the face or any other location on the body. This begins with a thorough embalming, followed up by using the proper chemicals to cauterize and dry the tissue. When looking at the challenges of facial cancer, especially the aggressive types that have ravaged portions of and overtaken the face, leaving the deceased nearly unrecognizable…we are left with few options. The first step is to analyze what we are working with, noting the recognizable features that remain, what tissue must be excised, and what skin remains viable. Consider what the underlying conditions are, and what we can do to reconstruct the excised tissue. Keep in mind that necrotic tissue does not embalm or firm, it must be completely removed. (Fig. 1) Examining the cancerous tissue as you excise will guide you on how much tissue to remove. Often, necrotic tissue will extend well into the side of the face from the exposed area. The cancerous tissue must be removed! Any potential point of leakage will create a possible embarrassing situation. After removing all the cancerous tissue (Fig. 2) it is time to thoroughly cauterize the entire area. In this particular case, I used a hexaphene-based pink gel as my treatment chemical. I applied it liberally, then packed the area with treated Webril Cotton, and enclosed the entire head in a plastic bag for approximately 18 hours. The gel not only treats tissue topically, but it will penetrate the tissue, draw out remaining moisture and embalm any remaining untreated tissue. (Fig. 3) Following the treatment, I test By Wally Hooker, CFSP, MBIE the area with cotton to see if any moisture remains. If any moisture is found, I treat it before proceeding. The dissection of necrotic tissue in this case has left a significant opening of the chin. (Fig. 3) This caused me some angst overnight, as I considered how to best reconstruct the chin. The biggest issue concerning me was ensuring the mortuary putty and waxes would remain in place on a vertical plane. Gravity can sometimes work to our disadvantage on these types of reconstruction. The swelling and stretching of the skin by the massive tumors left the chin opening too large to appear as natural. I decided to bring both cheeks in medially to recreate a natural form to the chin. To achieve this, I used ligature and brought both cheeks in. (Fig. 4) The ligature not only brought the cheeks into alignment, but it also created a web to assist in holding the mortuary putty in place, which will create the base to reconstruct the chin. (Fig. 5) I gently worked the mortuary putty through the ligature until it was firmly in place. I then tamped a piece of paper toweling into the putty and covered it with pore closer. This method creates a hard firm base to begin our reconstruction efforts. (Fig. 6) I used a small box fan to speed up the curing/ drying of this material. For the next step I used wound filler wax to rough in the opening, recreating the missing chin. (Fig. 7) For the finishing coat, I used surface restorer wax. To speed up the process, I use a handheld hair dryer to soften the wax in the palm of my gloved hand. As I worked it in with my spatula, I paid attenEmbalming 101 tion to the family-provided photos to recreate a natural appearance. (Fig. 8) Remember not to over-work the wax to a perfectly smooth appearance. As we age our skin has flaws, dimples, furrows, scars and such. Working it too smooth will appear un-natural. In cases such as these, it is easy to over-cosmetize while trying to cover the restorative materials and match them to the color of the skin. On this particular case, I chose to use my airbrush, mixing some tan, white and light brown cosmetic to create a primer coat. I applied this in very light coats from the neck up to the base of the nose. The rest of the face had good color from the embalming, and I didn’t want to over-do the cosmetics above the reconstructed area. I was able to use a light brown in the airbrush and created a very natural color. (Fig. 9) To protect the extensive wax work on the neck, after cosmetizing I applied several coats of aerosol hairspray to protect the area, then gently wrapped plastic around the neck prior to dressing. After carefully dressing and casketing, the final touches were completed under the lights at the receiving funeral home. (Fig. 10) I like to dress and casket prior to completing the final touches. Too many problems can occur during this process, so this gives us a little more control. What was going to be just a quick family viewing before closing the casket, became an open-casket service! Folks this is what it is all about! Going all-in to give the disfigured dead back to their families whole for a proper goodbye. I’ve said for years…if I can do it, you can do it! See you next month, be safe! Wallace P. (Wally) Hooker CFSP, MBIE, is the owner, funeral director and embalmer of Family & Friends Funeral Home of Wingate, IN. He and his wife, Janet designed, established and built their funeral home in 2004. Wally is a graduate of Worsham College of Mortuary Science, where he serves on the Advisory Board. He is Past President of the Indiana Funeral Directors Association and board member of North American Division of the British Institute of Embalmers. In addition, he has served as chief deputy coroner/investigator of Fountain County, IN for the last 24 years. F U N E R A L H O M E & C E M E T E R Y N E W S w w w . N o m i s P u b l i c a t i o n s . c o m Monthly Columnsonline at Facial Cancer Treatment Fig. 1 Fig. 2 Fig. 3 Fig. 6 Fig. 7 Fig. 8 Fig. 9 Fig. 10 Fig. 5 Fig. 4 1,000 families annually, this will be the third renovation to the Levett family’s largest chapel. “Due to the overwhelming response and commitment from the community, we needed to expand to continue providing the highest quality of service,” says Gregory Bernard Levett, Jr., an architect, and licensed funeral director. “With twelve private viewing suites designed after the most luxurious hotels in the world, we’ll be able to enhance our services and provide an unmatched guest experience.” The renovation will expand the location into a sprawling 28,000 square feet. “This is our gift to the community,” says Deana Levett. “The families of South DeKalb and metro Atlanta deserve a world-class facility, with a team of professionals providing world-class service in their time of need. We’re fully committed to delivering that to them.” Gregory B. Levett & Sons Funeral Homes and Crematory was established by Dr. Gregory and Betty Levett. “We opened our historic Avondale-Scottdale chapel first, then expanded to South Dekalb, Gwinnett and Rockdale. I believe it’s been our dedication to service and the support we receive and reciprocate to the community that’s allowed us to continue to grow,” says Dr. Levett. Groundbreaking on the project is set to begin mid-December 2022 and take approximately 12 months to complete. With four chapels and an on-site crematory, the firm which also specializes in international transportation through a vast, well-established global network, is on track to serve 2,200 families this year. ConstructionWorks, Inc of Lithonia, GA have been entrusted to oversee the construction of the project and the Levett’s collaborated with Dallas, TX architectural firm, JST Architects on the design. Levett to Undergo Massive Renovation Artist’s Rendering of the finished Levett Renovation SCOTTSDALE,GA— Gregory B. Levett & Sons Funeral Homes & Crematory, a longstanding institution serving the metro Atlanta area since 1980, is set to undergo a massive $6 million renovation this winter. The company’s CEO, Dr. Gregory B. Levett, Sr states, “We wanted to reinvest in the South DeKalb community and dedicate something special to the families we serve, they deserve it.” The 13,000 square foot expansion will feature an additional 250 parking spaces, two separate state of the art chapels and two banquet halls with inhouse catering services. Originally opened on June 15, 2000, and serving over Send Us Your News! We welcome news of the industry. info@NomisPublications.com PO Box 5159, Youngstown, OH 44514 CALL 1-800-321-7479 FUNERAL HOME & CEMETERY NEWS
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