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Plastic surgery helps a little boy breathe, see and live a better life

After facial reconstruction, 9-year-old Simao has new reasons to smile again.

Young boy with dark hair and glasses sits smiling at a glass-topped kitchen table.
Simao’s irrepressible personality is bubbling back to the surface after surgery.

It was hard for Lisa Meco to see her son, Simao, struggle with self-confidence. The 9-year-old boy was born with Tessier craniofacial clefts, a deformity of the face and head affecting both the bone and soft tissue. Simao’s facial malformations made him feel like he had a bad head cold 24 hours a day, 7 days a week—and made him more susceptible to infections. His facial asymmetry meant his eye pointed too far to the side, affecting his sight.

But this rare medical condition had devastating emotional effects, too. Lisa said the clefts made her son, who is friendly and outgoing by nature, much more reclusive. He was also often teased by bullies at school—to the point where he didn’t want to ride the school bus anymore. “It was really hard to watch,” she said.

Simao’s story took an important turn last year when he was referred to James Bradley, MD, a plastic surgeon at Cohen Children’s Medical Center. As one of a handful of surgeons who perform facial bipartition surgery, Dr. Bradley told Lisa that this unique procedure could help better align Simao’s face, repairing the clefts and giving it more symmetry. Even better? The procedure would improve his sight by relocating the position of his eye, and help his breathing by adjusting his nose and sinus cavities. 

While Lisa said she was initially concerned about the surgery, which would involve splitting Simao’s face in half vertically and then lining up the two sides, she said the entire team at Cohen Children’s was very supportive of both her and Simao. Dr. Bradley, in particular, she said, was incredibly reassuring, not only offering to do the surgery pro bono but taking the time to answer every question she had.

“He was amazing from day one,” Lisa said. “I always thought, from television shows, that plastic surgeons think they are better than everyone else. But Dr. Bradley proved that idea wrong. He was very thoughtful and caring, and explained the whole procedure to me without using complicated medical expressions I wouldn’t understand.” 

After seven hours of surgery, where Dr. Bradley partnered with Mark Mittler, MD, co-chief of Pediatric Neurosurgery, the doctors repositioned Simao’s eye and modified the structure of his nose. When they were done, Lisa said her son had a newly constructed face. The recovery did take some time, but she said Simao was well taken care of by the doctors, nurses and other staff.

“Our care team was always checking on Simao to see how he was doing,” she said. “But they were also checking on me to make sure I was OK, too. They were all so amazing, making sure we had everything we needed, that Simao wasn’t in too much pain and that all was going the way it was supposed to be going.”

Now, a few months after the procedure, Lisa said that Simao is thriving—his face looks great, and she is happy to report that her son has a lot more confidence.

Girl with brown hair and burgundy sweatshirt and boy in yellow shirt play video games on brown couch
Simao loves to try to beat his big sister, Maria, at video games.

“He’s doing really great,” she said. “At first, it was hard for him because of the scars, but he feels really good now. And he’s breathing much better.”

Today, Simao is back at school. And Lisa is happy to report that the kids who used to bully Simao have stopped. He’s doing well in his classes and is even attending social events like birthday parties, things that Simao often felt too uncomfortable to do before. The results of this procedure, Lisa said, are a “gift.”

Lisa said that she highly recommends Cohen Children’s, especially Dr. Bradley, to everyone. Simao says Dr. Bradley must have X-ray vision, calling his doctor a “superhero,” not unlike his favorite superhero, The Flash. 

“I wouldn’t think twice about saying people should go there,” she said. “I hope that no one would ever need to but, if they do, or if anyone was in the same situation as Simao, they would see how much they care about the patients and their families.” Even now, Dr. Bradley is always there to answer any questions she may have.

“You call him, he responds right away,” she said. “And he really talks to Simao. He asks him not just about his recovery but about school and friends. He’s just amazing. And it made all the difference to both of us.”