- Nicole Serna-Gonzalez, 11, became the first child to get a novel surgery to help her smile, per Cleveland Clinic.
- Serna-Gonzalez was born with facial paralysis that left her unable to move the right side of her face.
Nicole Serna-Gonzalez, an 11-year-old born unable to move the right side of her face, will get to smile broadly this holiday season after she received a novel facial reanimation surgery last year. Cleveland Clinic released details of Serna-Gonzalez's procedure on their website yesterday.
The Virginia native was born with unilateral congenital facial paralysis, a condition that left the right side of her face unable to smile, blink, show emotion, or even completely close one eye, according to Cleveland Clinic.
Serna-Gonzalez's parents told ABC that doctors initially said the condition would improve on its own, but later testing revealed nerves on her face did not develop when she was in utero, meaning the paralysis was permanent.
In June 2021, Serna-Gonzalez became the first pediatric patient to undergo a complex, 12-hour long facial reanimation operation to give her a symmetrical smile, per Cleveland Clinic.
Surgeon Patrick Byrne, chair of Cleveland Clinic's Head and Neck Institute, led Serna-Gonzalez's first-of-its-kind surgery, called a tri-vector gracilis free tissue transfer.
Byrne and his team first harvested a nerve and a muscle flap from the back of her leg. Surgeons then divided the leg muscle into three parts and placed them near her lip, the corner of her mouth, and near her right eye to enable a full smile and eye movement. Surgeons rewired the nerves from the functioning side of her face to the paralyzed side to allow for a natural, symmetric smile.
Serna-Gonzalez went home four days after surgery and has been working with physical therapists to learn how to use the newly constructed facial muscles. Her parents told Cleveland Clinic they notice Serna-Gonzalez's smiling ability improving with each passing week.
"We know from other cases the improvement we see at about one year out will continue for at least three or four more years," Byrne said in the release. "Especially at Nicole's age, we [expect to] see continued growth of the nerves and muscles into the face. The movements become more and more natural-appearing and symmetric."
Many people with facial paralysis spoke out about their condition this year after Justin Bieber revealed half his face was paralyzed as a rare complication from a viral infection.
"As you can see, this eye is not blinking, I can't smile on this side of my face, this nostril will not move. So there's full paralysis on this side of my face," Bieber said in an Instagram post.
Though Bieber's is hoping his symptoms will improve over time, surgeries like Serna-Gonzalez's are required to address permanent paralysis, according to Cleveland Clinic.
Byrne developed the three-muscle approach to allow for eye movement as Serna-Gonzalez smiles. Surgeons typically perform the surgery to just move the mouth, excluding eye movement.
"It couldn't have gone more smoothly," Byrne told Cleveland Clinic. "Nicole was a rock star. She managed any stress related to the surgery unbelievably well and bounced back really quickly."