Former beauty pageant contestant Julia Hernandez hasn’t smiled from ear to ear since 2013, but her sister and a surgeon are helping to change that.
Hernandez was 20, with multiple Los Angeles beauty pageant crowns under her belt, when she suffered a severe stroke. “A cluster of blood cells burst in my brain and it caused a hemorrhagic stroke,” she told ABC. Not only did the stroke affect her gait, but it paralyzed half of her face as well.
“I looked in the mirror and I saw my face for the first time, and I was shocked. I felt that my identity was completely gone,” the beautiful brunette explained.
The stroke curbed her crown collection, but it provided her with something even more valuable: a lesson in beauty. “There’s so much more beyond that, behind that, that makes you a valuable person. I was able to focus on what life really meant,” she said.
Unfortunately, this newfound outlook on life isn’t enough in the real world. “I really wanted to smile again,” Hernandez told Yahoo Lifestyle. “I know that beauty lies within someone’s soul, but society’s perception of beauty is different. I have found it difficult to get jobs that I am qualified for simply because of the way I look.” And science says she’s right. A 2010 Newsweek survey found that nearly 60 percent of 202 corporate hiring managers believed that an unattractive but qualified job candidate would have a tougher time getting hired (not that Hernandez is anything but stunning, full smile or half smile).
Her twin sister, Sophia, saw how badly Julia wanted her smile back — as well as her ability to breathe through her right nostril and blink her right eye — so she did some research. The med student at the University of California, San Francisco, didn’t have to look hard, as a doctor at the UCSF Medical Center happened to specialize in facial reanimation.
“Dr. Rahul Seth and I started the facial nerve center here at UCSF several years ago, and we treat many different kinds of facial nerve paralysis,” P. Daniel Knott, MD, professor and director of the division of facial plastic and reconstructive surgery at UCSF, told Yahoo Lifestyle. “Dr. Seth and I work with facial rehabilitation specialists, neurologists, oculoplastic surgeons, and otologists, as well as the general plastic surgeons to do this work. We perform facial nerve surgeries on almost a weekly basis.” According to ABC, he has a 95 percent success rate.
“I really wanted her to have the surgery because I know how much the stroke affected her, and this would potentially help her regain some sense of normalcy and help her feel like herself again,” said Sophia.
“I think this surgery can help me have a brighter future,” Julia said while recovering.
“Many people just don’t understand that we are at a new place for the treatment of facial paralysis at this point in time,” said Knott. His life and work experience has taught him that appearance and the ability to express emotion are critical. “The face is one’s window to the world, providing the ability to express emotion and interact with fellow humans.” Not only does facial paralysis inflict deep physical wounds, it’s psychologically damaging as well, “particularly in our current selfie-obsessed world,” Knott pointed out.
And while times are changing, facial paralysis is still particularly challenging for young patients and women in particular, he said, “among whom appearance and beauty are important for social acceptance and success; facial paralysis inflicts a severe social penalty for all of its sufferers.”
So on May 1, Hernandez went into an eight-hour procedure conducted by Knott.
“Julia was not nervous about the surgery,” Sophia said. “She felt very zen. She had done physical and occupational therapy already, and she felt that this was the last thing she could do to help her regain some function after her stroke. She was up for the challenging recovery that lay ahead.” From Knott’s perspective, she was a little nervous, “but at the same time she was very excited about it. She got a good night’s sleep the night before and was really looking forward to it.”
The operation is similar to a facelift in some ways. “Dr. Seth and I did a facelift approach — incisions placed in the hairline and in front of the ear so they would be pretty,” said Knott. They used a muscle from the inner, medial thigh called the gracilis muscle. “It’s a muscle that she won’t miss in her thigh,” he said. “We took it out with its artery, vein, and motor nerve, leaving her with a minor scar in the thigh. We also took some fascia [tough, fibrous tissue] from the lateral thigh.”
They then lifted her mouth/cheek with the fascia to make her lips and cheeks symmetrical and transplanted the muscle into her left cheek. They “reconnected the plumbing” (an artery and vein to an artery and vein in her neck) so that the muscle had blood flow. They also connected the nerve. For blinking ability, they put a platinum weight in her eyelid so she can close her paralyzed eye.
And we’re happy to report that the surgery was a success. “Her face looks much more symmetrical, and the transplanted muscle is doing well,” Knott reported. “She can breathe though her nostril now, and she can close her eye.” And she’ll be able to beam about that success soon. “We connected the nerve to one of the chewing nerves in her face, so that when she bites down, she will smile,” Knott explained. It will take about a year for the nerve to heal and start working, but in the meantime the fascia will hold the face in a good position. “She will hopefully get a normal-ish appearing smile.”
And while Hernandez will certainly be feeling more like her old self, she won’t be going back to old routines. “This experience taught her a lot about service, but she wants to focus on writing and her future career [instead of beauty pageants].”
“For myself as a microvascular facial plastic surgeon, I love being able to restore smiling, movement, normalcy, and beauty for my patients,” said Knott. “It isn’t often that one can really transform a patient’s life in such a fundamental way.”
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