Annie O’Neill/ Cleveland Clinic
A Virginia girl is getting a brand new smile thanks to a first-of-its-kind surgery.
Nicole Serna-Gonzalez, an 11-year-old girl from Virginia, was diagnosed with unilateral facial paralysis at birth. The condition, which doctors say could've developed during childbirth if her face was pressed against something, prevents Nicole from closing her right eye, smiling on the right side of her face or using that side of her face to show emotion.
"In the beginning, we had hope that it would go away with time, though we didn't think much of it," her mother, Carolina Gonzalez, told USA Today. "It didn't affect her in any way except that she couldn't smile. She could eat and her speech wasn't impaired by it. She could swallow."
Although Nicole liked having a different smile, Carolina said other people often made her feel uncomfortable when asking about it. Her family spent years trying therapy and searching for treatments before meeting Dr. Patrick Byrne in 2018 and planning a life-changing operation for the following year.
The surgery is called a trivector gracilis free tissue transfer, which is a 10-hour facial reanimation operation that will allow Nicole to slowly develop the use of the right side of her face and smile.
Byrne told the outlet that finding someone to treat the condition is difficult and his team of surgeons spent years trying to perfect the procedure. However, Nicole's surgery was delayed due to the COVID-19 pandemic and Byrne moving from Johns Hopkins to Cleveland Clinic.
"They were a little lost for a while and ultimately tracked me down and showed up in Cleveland," Byrne said. "We were able to proceed with treating her."
Courtesy Carolina Gonzalez Nicole Serna-Gonzalez after the facial surgery
Nicole's family traveled to Cleveland and underwent the facial reanimation operation in June 2021. She is reportedly the first to undergo the surgery, which is also the first procedure to produce a contraction of the lower eyelid and around the eyes, creating a natural smile.
Byrne said Nicole's new smile "looks fully alive and dynamic," noting that there's still some normal swelling that typically occurs the first few years after surgery.
He explained to USA Today that it takes four to 12 months for the muscle to wake up because the nerves have to grow and activate, and the healing process will continue for several years.
"She has a beautiful smile," Byrne added. "There's really nothing, to me, more fascinating than this nuance of facial expression because it really is what makes us human in so many ways."
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Nicole's father, Sergio Serna, explained that the family will continue following up with Byrne in the next few years to make sure her recovery is on track.
"We can rest knowing that we did everything that we could," he said. "She's happy. We're happy."
Her mother Carolina added that Nicole has been thrilled since the surgery. "She sees the pictures now and she can tell a big difference. She likes her smile now. She liked it before too."
She also encouraged other parents to teach their children to be more accepting of others' differences, even if kids are just curious. "It's a good lesson that I've learned as a mom," Carolina told the outlet.