Four-year-old Natalie Wright faces a bathroom mirror, brushing her teeth and simultaneously criticizing her face. She raises her small hand to her left cheek, gently lifting it up so it matches the right side of her face. Mother Dana Wright passes by, knowing that all her daughter wants is to smile.

Natalie, now 15, is living her dream: As of April 19, she will be able to see her mouth spread naturally into a full smile. Natalie received Iowa’s first facial-reanimation surgery to alleviate her facial paralysis at the University of Iowa Hospitals and Clinics.

“It’s just a boost of confidence,” said Natalie, a Utah native. “[My self-esteem] wasn’t ever bad or anything, just normal teenage girl stuff. [Students] at my school weren’t really mean, they would more just ask questions or give me looks.”

When Natalie was 2, her parents noticed she was drooling more than other children, as well as noticing her face drooping on her left side. She was taken to her doctor, who found a tumor in her brain. Five days later, surgery was performed to partially remove it. The surgery, in addition to the tumor  surrounded by nerves, caused Natalie’s left side of her face to become paralyzed.

This caused a drooping in her mouth as well as the loss of hearing and sight on her left side.

A “happenstance event” occurred when Natalie and her parents were discussing her situation with their neighbors — they mentioned their nephew, UI Clinical Assistant Professor Douglas Henstrom, was an expert in a special surgery that may be exactly what the Wright family was looking for.

Natalie said although there was some apprehension about such an innovative surgery, she was excited at the prospect of being able to help her paralysis.

“We started it last year,” Natalie said. “I never really thought about it. It was crazy to think I could actually change [the facial paralysis].”

Natalie underwent an 11-hour surgery on April 19. This is the second part of the procedure, called facial-reanimation surgery. The first portion occurred last year, focusing on the nerves, and this surgery focused on entering tissue into her face and connecting the two together. The nerves and tissues put into her face were taken from her right leg, and although Natalie had to get used to walking again, the surgery was successful.

Her surgeon, Henstrom, who joined the UIHC in 2011, had done the procedure many times in other states.

The first facial reanimation surgery occurred in 1976, but advancements have been made in roughly the last 15 years. Henstrom said it is difficult for patients to find a specialist for the surgery.

“With Natalie, we had gone to the same high school, we had some of the same teachers,“ said Henstrom, the director of facial plastic surgery in the Carver College of Medicine Otolaryngology Department. “I had a pretty special situation to be able to come full circle [by operating surgery on Natalie].”

Natalie will return to enjoying drawing, baby-sitting, and finishing her sophomore year of high school. She hopes to become a child-life specialist one day, and her father said her trials with her tumor have not numbed her compassion or optimism for life.

“She really loves playing with 2-4-year-olds,” said John Wright, the father of Natalie. “I think it’s because those are the years of her childhood she didn’t really get to experience [due to tumor complications], and she’s reliving them now. I’m an optimist, and Dana’s the most empathetic person in the world, and Natalie is a mixture of it all.”

Dana Wright credits the family’s friends, extended family, and faith for helping them through the tougher times.

“Really, truly, we’ve been helped through faith, friends, and family,” she said.

Natalie said although most teenagers have not gone through brain surgery as she has, most people can relate to her story about the importance of accepting yourself and others — regardless of appearance.

“I’ve worked in peer tutoring and just realized everyone’s different,” Natalie said. “Everyone thinks differently, people look differently. I just think it’s cool to share my story and inspire people. I hope I inspire people, anyway.”