Reyli Hernandez is a fun-loving, 10-year-old boy who enjoys running and playing with his friends and family. He dreams of becoming a doctor when he grows up, maybe because Reyli has spent much of his young life surrounded by doctors, having undergone more surgeries in 10 years than most will experience in a lifetime.

Born with an extreme case of Tessier clefts, a series of severe facial clefts that involve more than just the lip and upper jaw, Reyli has been a patient of the Texas Cleft-Craniofacial Team at Children’s Memorial Hermann Hospital and McGovern Medical School at UTHealth for quite some time.

As a baby develops during early pregnancy, body tissue and cells from each side of the head grow toward the center of the face. The joining of tissue forms the lips, mouth and nose. When the tissue does not completely fuse before birth, it leaves an opening, or cleft, which can cause problems with speaking or feeding. Cleft lip and palate are common birth defects that affect an estimated 7,000 U.S. babies born each year, according to the U.S. Centers for Disease Control and Prevention. Tessier clefts, however, are much more rare, only occurring in one out of every 150,000 births.

“Reyli is a special case for us,” said Matthew Greives, M.D., craniofacial and pediatric plastic surgeon at Children’s Memorial Hermann Hospital and assistant professor of pediatric plastic surgery at McGovern Medical School. “His clefts extended not just through his lip, but up through his nose, cheek, right eye and to the frontal bone of his forehead. He has already undergone four surgeries with our cleft team: one for his lip, one for his palate, one revision for his nose and cheek area, and, most recently, a complex procedure that involved Reyli’s entire face.”

On Oct. 20, 2015, Reyli underwent an intricate, eight-hour procedure, called a facial bipartition, to reshape his face.

“The goal was to bring his eyes closer together and widen his palate as the same time,” said Dr. Greives. “It was a big operation that covered the entire face and skull. By putting him through this major procedure, we laid the foundation for future cosmetic surgeries he will require as he gets older.”

The complex surgery requires careful and extensive preparation. Three-dimensional printed models of Reyli’s skull were used not only to help plan the surgery but they were also utilized during the actual procedure to guide physicians through the process.

A multispecialty collaborative team is involved, including Manish Shah, M.D., pediatric neurosurgeon at Children’s Memorial Hermann Hospital and the Memorial Hermann Mischer Neuroscience Institute at the Texas Medical Center and assistant professor in the division of pediatric neurosurgery at McGovern Medical School.

“My job was to protect the brain so Dr. Greives could recontour the bone and make sure everything looked pretty,” said Dr. Shah. “Reyli’s procedure was very extensive so it took a team of experts to make sure everything worked effectively. It’s an honor to be part of this team and to help make these complex procedures happen so seamlessly.”

Nearly a month after the surgery, Reyli was back to his old, active self.

“It’s very difficult emotionally to prepare for a major surgery like the one Reyli most recently went through,” said Marissa Rodriguez, Reyli’s mother. “But everything came out excellently. He’s so full of energy and joy.”

Throughout it all, Reyli has maintained a positive and infectious attitude, braving each procedure with a kind of maturity and courage that has impressed his family, physicians and staff.

“Reyli still has several surgeries in his future, but we have to allow some time for his skull and muscles to heal,” said Dr. Greives. “So, for now, we want him to just enjoy being a kid.”

Helping to Build Dreams

For the pediatric plastic surgery team at Children’s Memorial Hermann Hospital, Reyli’s treatment underscores the strengths of a multidisciplinary team skilled to handle the most complex cases. But his procedure might not have been possible if not for recently retired Houston Texans player Chris Myers and his wife, Jenny. The Myers family has been a regular contributor to the Texas Cleft-Craniofacial Team since their 4-year-old son, Keane, was born with a cleft lip and palate and treated at Children’s Memorial Hermann Hospital by John Teichgraeber, M.D., Co-Director of the Texas Cleft-Craniofacial Team at Children’s Memorial Hermann Hospital and professor in the Division of Pediatric Plastic Surgery at McGovern Medical School at UTHealth.  For the Myers family, Reyli’s story struck an emotional chord.

“When we decided to raise money through the Dreambuilders Foundation, we had no doubt that we wanted these funds to go to the pediatric plastic surgery program at Children’s Memorial Hermann Hospital,” said Jenny Myers. “We wanted other families to share the incredible experience that the outstanding team provided for our son, Keane. The opportunity to assist families by easing the financial burden that comes along with cleft surgeries is extremely humbling.”

Children’s Memorial Hermann Hospital recently held a special event to thank and acknowledge the Myers family. Guests were asked to make a contribution to the Pediatric Plastic and Reconstructive Surgery Program in lieu of a farewell present for the Myers, who moved to Philadelphia this summer.

“The Myers’ generosity has assisted a number of families – not just Reyli’s – who otherwise might not have had access to the procedures needed to help their children,” said Dr. Greives. “Our department operates like a family, and the Myers have been an integral part of that family for many years now. We wish them all the best in their recent move. Their compassionate hearts will be missed.”

July is National Cleft & Craniofacial Awareness & Prevention Month. It’s a time when friends and families of those with craniofacial differences can educate about facial clefts. If you would like to donate to the pediatric plastic surgery department at Children’s Memorial Hermann Hospital, please visit the Memorial Hermann Foundation.

Take a look at the before and after of Reyli’s most complicated procedure performed by the Texas Cleft-Craniofacial Team at Children’s Memorial Hermann Hospital and the McGovern Medical School at UTHealth.