Special Report: The Changing Face of Cynthia
A young Montreal girl has gone through an incredible journey.
Eleven-year-old Cynthia Moldonado has a deformed face, with all the problems that come with it.
But she has new hope thanks to the Montreal Children's Hospital, where modern science and technology provide a bright new future.
Cynthia was born with Crouzon Syndrome, a genetic disorder that causes the bones in a baby's skull to fuse, preventing the head from growing normally.
Cynthia's eyes don't close completely, even when she sleeps.
The middle of her face is caved in, constricting her airway and causing sleep apnea, which is when a person stops breathing periodically through the night.
She also has a hearing problem and a severe underbite.
Breathing and eating are very difficult.
Cynthia has a great attitude, but she's still a young girl moving quickly toward adolescence who keenly feels the stares and judgments of others.
Her father, Gelby Moldonado, tells CTV's Cindy Sherwin that Cynthia is the apple of his eye.
"She's beautiful to me. I think every father looks at their kids as the most beautiful in the world."
But sadly, he says the outside world has not been as kind. People often assume Cynthia is mentally disabled.
"It does hurt my older daughter. Once she cried because another kid made fun of Cynthia."
The young patient tells CTV's Cindy Sherwin that the life-changing operation can't come soon enough.
"I'm having an operation. I'll have normal eyes," she says.
Cynthia's hope comes in the form of a radical new surgery that's only being performed in Quebec on a regular basis.
The operation at the Children's hospital is so complex that two surgeons worked for six hours in late January to complete the procedure.
"What we're trying to do is separate the facial structure from the cavity that contains the skull," Dr. Mirko Gilardino, director of craniofacial surgery, told Cindy before the operation.
CTV News cameras followed Cynthia into the operating room on January 25.
The surgeon makes an ear-to ear incision in Cynthia's scalp. Her forehead is removed, exposing her brain.
Her face is actually peeled off and then, with a surgical chisel and hammer, Dr. Gilardino gets to work cutting bones so that the whole face becomes mobile.
By the end, Cynthia has been equipped with a device called an External Halo Distractor.
It's attached with screws and wires and is designed to pull her face gradually forward like braces on teeth.
The procedure will improve her looks and her medical prognosis.
Without this operation Cynthia's breathing would worsen, causing brain, heart and lung problems.
The old approach required bone grafts and steel plates and had a much higher risk of infection.
Cynthia's parents will be the ones to turn the screws on Cynthia's distractor twice a day. Each turn advances Cynthia's face.
The change is noticeable about 12 days later, Dr. Gilardino tells Cynthia and her family in an examination room.
"What we see right away is that the upper teeth now have come forward at least 10 millimetres," he says.
The screws will keep turning until her face is actually over-advanced, something the doctor says can be stressful in its own right.
"It's the hardest part for the parents," he says. "They go from seeing a face that's . . . relatively normal (to) over corrected which looks abnormal again.
"But she's got at least five or six years of facial growth to go so I have to push this face forward so that the rest of her face can sort of grow into it."
It's clear that the post-operative period is the toughest time for Cynthia. She says her neck and back are sometimes sore and that the pain wakes her up every two hours.
But the soreness will subside and progress is impressive, something that encourages her father Gelby.
"Now I'm worried that she's going to look too beautiful," he says. "I gotta watch out for the guys there."
One month later
CTV checked back with Cynthia in late February, 30 days after surgery.
She had lost a lot of weight due to her liquid diet but she was alert and doing her math homework.
She also has reason to smile.
"I feel pretty," she says.
The halo will be removed in April or May once the bones are set.
Cynthia's excited, but right now all she really wants is to be able to eat a piece of pizza.