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Young Boy with Moebius Syndrome Smiles After Surgery

By Erin Hull July 02, 2018
Colton Southern smiling

Colton Southern had plenty to smile about after surgery last year. In fact, it was the first time in the eight-year-old boy’s life that he was able to show how happy he was. Colton’s facial muscles were so weak when he was born that he was unable to show expression. Facial reanimation surgery at Duke Children’s Hospital brought a smile to Colton’s face -- and to the faces of his thankful family.

Born with Moebius Syndrome

Colton was born with Moebius syndrome, a rare condition that causes weak or paralyzed facial muscles. Colton was unable to smile, frown, lift his eyes, or show any expression. “From the time he was born until he was 11 months old, we didn’t even know if he was in there,” recalled Samantha Southern, Colton's mother.    

Around his first birthday, Samantha took Colton to see Jeffrey Marcus, MD, a Duke pediatric plastic and reconstructive surgeon. Dr. Marcus followed Colton’s progress for years until the boy was old enough to benefit from surgery.

“He wanted to be like his brothers,” Samantha said. “He would say, ‘Why can’t I smile?’”

Smile Surgery at Duke

When Colton was seven, Dr. Marcus determined that he was ready for facial reanimation surgery. During the procedure, which is sometimes referred to as “smile surgery,” Dr. Marcus and microsurgeon Scott Hollenbeck, MD, transplanted a muscle from Colton’s thigh to one side of his face. A year later, the procedure was repeated on the other side of his face.

"Without having a talented microsurgeon, these cases can’t be done with the level of success that we have,” Dr. Marcus said. “Our program works because we have two surgeons with complementary expertise."

Colton and his family were excited to see his smile after both surgeries, taking lots of pictures and making FaceTime calls. "He literally came out smiling,” Samantha said.

A physical therapist is often necessary to teach a patient how to use their new facial muscles. The process can take up to six months; Colton taught himself to smile in just two.

Colton Can Smile

News of Colton’s new smiling face spread quickly. When he returned to school, one of his teachers, Miriam Guthrie, said Colton was excited to show off his new smile to her and to his friends.

Today, hanging on the wall beside her desk is a picture Colton drew for her when he returned to school. It’s a picture of himself, smiling. Written across the page are the slightly misspelled, but declarative words: “Colton Can Smile.”

Colton's teacher holds up a picture he drew of himself smiling

Colton's teacher holds up the photo he drew after he started smiling.

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Facial Reanimation