A girl with abnormal face development can now smile and laugh again months after she underwent a face reshaping surgery.

Violet Pietrok from Portland, Oregon was born with a condition known as frontonasal dysplasia, which is characterized by the malformation of the head and face. The abnormal development before birth is so rare that the National Institutes of Health says there are only 100 known cases of the condition.

Because of her rare disorder, two-year-old Violet's facial features, particularly the spaces between her eyes and nose, were widened. The child also had a cleft in her face and a large growth over one of her eyes. She likewise had no cartilage in her nose.

In October, Violet underwent a major surgery at the Boston Children's Hospital to have her face reshaped. Because of the distinct way that her skull was formed, the hospital's plastic surgeon-in-chief, John Meara, used 3D printing technology to come up with models of the child's skull.

Meara made about five different models of Violet's skull from the time she turned a year old. The doctor said that he used the 3D printed models, which were based on magnetic resonance imaging pictures, to see how Violet grew and developed as well as to practice the cuts and incisions that he had to make during the operation.

The molds likewise gave Meara and the other surgeons an idea of what possible problems they may encounter during the surgery. It also gave them a better picture of what they would be working with. The 3D printed models proved valuable during the nine-hour surgery as well. Meara used it whenever his team encountered complications during the procedure.

"3D printing is a way to let you see where you're going," Meara said. "For example, we wanted to move the eyes closer together and we can see where there might be problems. This way, we can just do it again in practice rather than having it have to be right the first time."

Although there has been limited research on the benefits of 3D printing technology or surgical simulations, researchers from the Department of Veteran Affairs have shown that making teamwork exercises prior to an operation can reduce odds for patient deaths and injuries by up to 18 percent.

Exercises in the operating room are particularly helpful in complicated procedures, such as the one that Violet went through. Meara's team had to be careful with the surgery, making sure that it would not interfere with Violet's brains and other nerves. It also took them months to prepare for the operation.

Violet's parents said that they were comforted by the surgery, albeit the girl still needs more operations, such as those that would add cartilage to her nose and bring her eyes closer together.

It will also take a long time before the child would no longer catch the attention of the people she meets, but Violet does not seem to care. She even plays with some of the strangers she meets.

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