Note: This story is part of the 2008 Seton Family of Hospitals Annual Report It is always a privilege to include the stories of people who have experienced remarkable recoveries and are moving on with their lives. We are proud to be a part of their journey.

Gaze into the face of 16-month-old Lucio Torres and you'll see his eyes they gleam, keen and alert, almost mirthful. Lucio, despite his condition, is a happy little boy.

Lucio was born with a teratoma, a medical term from the Greek that roughly translates as "monstrous tumor." At birth, the side of Lucio's head was grossly misshapen, the bulging tumor threatening his left eye, ear and brain.

"Before, when you had these kinds of problems, you were sent to Dallas or Houston," said Adriana Da Silveira, MD, DDS, PhD, a craniofacial orthodontist and part of a remarkable team at Dell Children's Medical Center of Central Texas that continues to work on Lucio.

When Lucio was four months old, doctors removed the tumor. "Lucio's surgery was very complex because it was so close to the brain, close to the eye, close to the ear," Dr. Da Silveira recalled. "It was a very long operation, performed by a craniofacial surgeon and a couple of neurosurgeons."

Lucio's surgeons are some of the best in the business and they're located in Austin at Dell Children's: Patrick Kelley, craniofacial surgeon and medical director of Pediatric Plastic Surgery; Timothy George, a pediatric neurosurgeon who came to Dell Children's after serving as associate professor of Neurosurgery, Pediatrics and Neurobiology at Duke University; and Patricia Aronin, a pediatric neurosurgeon who previously was chief of Pediatric Neurosurgery at the Children's Hospital of Alabama and associate professor of Neurosurgery at the University of Alabama in Birmingham and then associate professor of Neurosurgery at Wayne State University and the Children's Hospital of Michigan.

"It was a very long operation," Dr. Da Silveira said. "After they removed the tumor, it left a huge defect on Lucio's skull."

Efforts to correct that asymmetry then began. Dr. Da Silveira made a plaster cast of Lucio's face to determine just what facial features needed work. She contacted an Arizona company that manufactures corrective infant "helmets," which protect the head and apply corrective pressure to deformities of the skull. Because Lucio's cheekbone was dramatically deformed by the tumor, Dr. Da Silveira asked the company to design a special attachment that would reform the cheekbone. However, the extension was not effective on the needed area.

Undeterred, Dr. Da Silveira contacted a local orthotics designer, Arie J. "Bud" Bronkhorst with Hanger Prosthetics & Orthotics Inc., who became another member of Lucio's team. Working with Drs. Kelley and Da Silveira, Bronkhorst designed a special cheek guard that slowly reformed Lucio's cheekbone.

Under the watchful eyes of the team of doctors and nurses, and with the help of Bronkhorst's orthotic helmet, Lucio's face is carefully being reshaped. He continues to grow more or less normally that is, "normal" for a boy not yet two years old who has undergone so much surgery.

And the hard reality is that Lucio faces more surgery, "probably until he stops growing," Dr. Da Silveira pointed out. He'll need orthodontic care, bone grafts and more reconstructive surgery. So, the world-class team assembled to treat Lucio isn't finished yet. But, according to Dr. Da Silveira, Lucio has a bright future.

"He's all smiles."

Craniofacial and Plastic Surgery Center

Dell Children's Medical Center

The Dell Children's Craniofacial and Reconstructive Plastic Surgery Center is attracting specialists from diverse disciplines for the treatment of children with congenital malformations or traumatic injuries of the head and face. The center has just expanded capabilities in the areas of pediatric craniofacial orthodontics and pediatric hand surgery.

Patrick K. Kelley, MD

Plastic Surgery

Dr. Kelley is a native Texan. He completed his medical school and plastic and reconstructive surgery training at Baylor College of Medicine in the Texas Medical Center, Houston, TX. Dr. Kelley is chief of the department of Craniofacial, Plastic and Reconstructive Surgery at the Dell Children's Medical Center of Central Texas. His primary focus is craniofacial surgery in Children and Adults as well as general pediatric plastic surgery and microsurgery.

Adriana C. Da Silveira, DDS

Orthodontics

Dr. Da Silveira has a Certificate in Orthodontics from Eastman Dental Center/University of Rochester and is a Diplomate of the American Board of Orthodontics. Specializing in the treatment of cleft lip and palate and other craniofacial syndromes along with surgical orthodontic treatment of dental facial abnormalities, she also provides orthodontic treatment to patients with special needs and those who have complex medical problems. She holds a Ph.D. and Master degrees in Oral Biology from the University of Florida. Prior to joining the Dell Children's craniofacial program in Austin, she was an Assistant Professor at the Department of Orthodontics and the Department of Surgery at the University of Illinois at Chicago, and the Chief of Orthodontics at the Craniofacial Center for seven years. She also received a Doctor of Dental Science degree from the University of Illinois and was an Orthodontist at the Shriner's Hospital Craniofacial Team in Chicago.