MUKILTEO, Wash. — Childhood injuries are part of growing up. But after a stray dog attacked and severely injured a Western Washington boy, it took a team of specialists at Seattle Children’s to put everything back together again.

"It's been a pretty big ordeal. One I didn't ever think we'd go through. The dog just kind of lunged, jumped up and grabbed his nose and pulled him down." Tina Beck described what happened to her son Tristan.

It’s taken twelve months to repair the damage caused by that stray dog. One year later, 9-year-old Tristan plays with the family’s two lovable dogs, Carmel and Cody. 

The fact that Tristan can enjoy a friendship with dogs without fear is confirmation as to how well he's recovered.

"It's a traumatic event, I think, to have a dog biting at a nose and a body part coming off," explained doctor Raymond Tse, a plastic surgeon at Seattle Children's.

Tristan was with his sister dropping off food for a party when an unfamiliar dog attacked in a parking lot.

"My daughter said, 'Mom, Tristan just got bit by a dog.' And I'm thinking, okay maybe on the leg or the fingers, wasn't really something bad. And then they walked him in and I just barely pulled the shirt away and realized, oh my gosh, this is not something I can take him to the hospital. I need 911 here now,” explained Tina.

The dog bite took Tristan's nose and part of his cheek.

"It kinda, it felt like really cold, my nose, really cold and weird," said Tristan.

The ambulance delivered Tristan and his mother to Seattle Children's where the Craniofacial Team was called in to help.

Dr. Tse was the primary physician who worked with the Beck family.

"It struck me when I actually saw him, and we started looking for the tissues to put back together, and they were not there. They were all missing, and his nose had been bitten off, part of his cheek was missing as well. So, all the parts were actually, truly missing,” said Dr. Tse.

"This wasn't something that could be fixed just overnight. This was going to take some time," said Tina.

"So, when tissue is missing then we've got to start from scratch, and rather than putting a nose back together, we've got to create something. And so that does raise the complexity of things considerably," said Dr. Tse.

"The nose is the keystone of the face," explained Dr. Tse, so a primary focus when creating a nose involves aesthetics, but also function. Tristan needed a nose that he could breathe through.

"It involved multiple stages. It involved a lot of careful planning. It involved a situation where we needed to construct something that was built of all sorts of tissue types. So not just skin, a nose has cartilage in it to give it structure, it's got lining in it to allow the inner passage of the nose to actually function normally. So, there's a lot of different parts to a nose that are beyond what you normally kind of see by eye," said Dr. Tse.

The process took time and many procedures. The Craniofacial Team at Seattle Children’s offers comprehensive care because the physical medicine wasn't the only consideration.

"Tristan's whole time he was there, he always had that smile, that glow on his face even with the bandage over his nose you could still see it. As a mom I was really pleased to see that he still had his sparkle,” said Tina.

“We've got a kid who wouldn't show his face. And now he's okay showing his face and that to me was kind of the 'eureka,' that was the moment where I think we've really done something worthwhile. Yeah, I think it just reassures us that we're doing the right thing and moving in the right direction,” said Dr. Tse.

One of the most amazing things about this story is 9-year-old Tristan’s relaxed acceptance of their family pets.

Psychological wounds are often harder to heal than physical ones and as Dr. Tse said, Tristan is moving in the right direction.