Pediatric Plastic Surgery
Patient Stories | Zakary and Encephalocele

A New Face for Zakary

When Valeka Riegel visited Cincinnati Children’s with her son Zakary, his surgeons were thrilled with how far he had come. It was a far cry from when she was pregnant. Midway through her pregnancy, a fetal MRI detected a rare defect called an encephalocele.

Valeka: “So of course I did what we should never do and got on the web and Googled it, and that’s when my panic began.” 

Valeka’s son had a large opening in the bone between his eyes, through which tissue and a fluid sac protruded. Until Zakary was born, she wouldn’t know if the encephalocele was cancerous. The Cincinnati Fetal Center team called in Charles Stevenson, MD, a pediatric neurosurgeon at Cincinnati Children’s to look at the MRI.

Dr. Stevenson: “At that point I quickly knew what would be required following his delivery, and then I honed a friend very quickly and called Dr. Pan, because I knew we would need a complex reconstruction of his face, and the nasal bridge there in order to make this work.” 

Dr. Pan is Brian Pan, MD, a pediatric plastic surgeon at Cincinnati Children’s. Although the surgeons had seen something like this only once before, they were prepared to handle it. As for Valeka, nothing could prepare her for what she saw when Zakary was delivered Dec. 29 of 2016.

Valeka: “The growth covered from his eyes down to his mouth, and when you looked at him as a baby, all you saw was a little mouth.”

Zakary needed a feeding tube and supplemental oxygen. He spent 4 ½ months in newborn intensive care at Cincinnati Children’s before he grew enough to have the operation. Doctors Stevenson and Pan used that time to plan.

Dr. Stevenson: “There were several steps involved in terms of exposing the forehead, exposing the defect, amputating all of that tissue, preserving the normal brain, and then reconstructing all the normal layers, or barriers, which had formed.”

The operation was successful, and the tissue was found not to be a cancerous tumor.

Valeka: “I walked into that room and I just cried.  Because I just couldn’t imagine seeing a face. I couldn’t imagine seeing his eyes, and his mouth and his nose.  And I just kept staring thinking, there’s really a baby in there.”

Zakary and Valeka moved to the area to be closer to Cincinnati Children’s. Both she and the surgeons can now look back on the past year with gratitude.

Dr. Pan: “Actually, I’m very grateful for her putting her trust in us to take care of her son.  It’s a great privilege and honor.”

Valeka: “You’re an absolute blessing, from valet services to housekeeping, the nurses, the doctors, the volunteers, I thank you. We both thank you."