The road to prison is clear for Elizabeth Holmes, the fallen CEO of Theranos, as her appeal to remain free was denied by a court on Tuesday. Holmes, once a Silicon Valley sensation, is facing an 11-year sentence and a hefty $452 million restitution fee for her role in a fraudulent blood-testing scheme.

The Ninth Circuit Court of Appeals confirmed the verdict almost three weeks after Holmes executed a last-minute legal strategy to postpone her prison term, initially set to begin on April 27. The commencement of her sentence will now be rescheduled by US District Judge Edward Davila, who initially sentenced her in November.

The transition to prison life will mean a separation for Holmes from her partner, William "Billy" Evans, and their two young children. Holmes was convicted of four counts of fraud and conspiracy in January 2022, during her pregnancy with her daughter, Invicta.

While Judge Davila has suggested a women's prison in Bryan, Texas, for Holmes, the final decision rests with the federal Bureau of Prisons, who has yet to confirm the facility.

Ramesh "Sunny" Balwani, Holmes' former lover and Theranos associate, is already serving a nearly 13-year sentence after being convicted of more extensive felonies in a separate trial. Balwani, 57, was imprisoned in a Southern California facility after losing his appeal to remain free while contesting his conviction.

Holmes' conviction highlighted a culture of greed and arrogance that has permeated Silicon Valley over the last two decades. The former CEO, who founded Theranos after dropping out of Stanford University, was found guilty of deceiving investors with false claims about her company's blood-testing technology.

Despite being originally indicted on 11 charges, Holmes was acquitted of four, with the jury unable to reach a verdict on the remaining three. The defense team sought leniency due to her status as a mother and daughter and her potential for future good in society.

Holmes' conviction followed a 46-day trial that featured her testifying in her defense. She alleged emotional and sexual abuse from Balwani and maintained her belief in Theranos' revolutionary potential in the healthcare industry.

However, her vision crumbled after a Wall Street Journal investigation and regulatory reviews revealed serious flaws in Theranos' technology. Despite raising nearly $1 billion from high-profile investors, all investments were lost.

The restitution ruling from Judge Davila stipulates Holmes and Balwani to pay the largest sum of $125 million to Rupert Murdoch. They are also required to pay $40 million to Walgreens, and $14.5 million to Safeway.

Despite the setback, Holmes' lawyers continue to challenge her conviction, alleging errors and misconduct during her trial. Their request for Holmes to remain free during the appeal has been denied by both Davila and the Ninth Circuit Court of Appeals.