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Kevin Portillo practices how to smile every day. Normally, he does it after brushing his teeth, but also whenever he goes in the bathroom or wherever he finds a mirror.
He puts his index fingers on either side of his mouth and lifts them gently. He wrinkles his face like to kiss, then opens his lips in a big O, trying to warm his facial muscles. Practice Mona Lisa's Smile discreetly and with lips together, like the broad that teaches all teeth .
You are supposed to do your exercises every day. But, being 13 years old, she sometimes forgets, even if she is aware of its importance.
"I need to stretch my cheeks," she says. "I'm doing it for a few minutes, I have to do it every day." He exercises them so much that sometimes his jaw hurts.
Kevin was born in New Jersey with a rare malignant tumor a kaposiform hemangioendothelioma (HEK), which covers the left side of his face, tightening his left eye and pushing your nose to the right. Immediately after his birth, the doctors transferred him to another hospital in another state: the Children 's Hospital of Philadelphia. His mother saw him only eight days later.
The doctor told the parents that Kevin was unlikely to survive. But he did it.
However, this great tumor and the damage it caused prevented it from doing one of the most basic things that humans do: smile
On a physical level it is very clear. There are 17 pairs of muscles that control the expressions of the human face and another pair, the orbicularis, which is a kind of ring that surrounds the mouth.
The basic smile that curls upward is mainly obtained two pairs of muscles known as major and minor zygomatic. The two connect the corners of the mouth with the temple, pulling the lips up. They usually act accompanied, depending on the emotions and thoughts, the levator muscle of the upper lip.
This is away from the realm of physiognomy as the smile becomes something enigmatic. This contraction of several facial muscles has left its mark throughout history, archaic smiles of Greek sculptures known as kuros, made 2500 years ago, to emoji these small images that make it flavor our messages.
There are differences between the bades (women tend to smile more) and culture. The smiles are definitely communicative: people smile more in public than when they are alone and do more when they interact with others.
— A Mysterious Smile —
Scientists have shown that smiles are much easier to recognize than other expressions. What they do not know, that's why.
"We can recognize smiles very well," says Aleix Martinez, a professor of electrical engineering and computer science at Ohio State University, where he founded the Laboratory of Computational Biology and Cognitive Science. 19659003] "Why is this true?" Nowadays no one can answer it We do not know I can show you an image only 10 milliseconds and you can tell me if it's a smile It does not happen expression "
Surprisingly, it takes 250 milliseconds to recognize fear: 25 times more than a smile. "Recognizing fear is fundamental to survival, while a smile …" Martinez testifies "But that is how we are programmed."
Other studies have shown that smiling faces are considered more familiar than neutral faces . Scientists like Martinez have the theory that smiles, as well as frownings and other facial expressions, are remnants of a distant pre-human legacy of the human being.
Human language began to develop there at 100,000 years they go back even further, maybe until the time of our first ancestors.
"Before we could communicate verbally, we had to do it with our faces," says Martínez.
Interpreting the nuances of a smile is a challenge when it comes to the history of art or interpersonal encounters or the avant-garde of artificial intelligence. In a 2016 study, for example, he interviewed thousands of people in 44 cultures about a series of photographs: four with smiles and four with smiles.
Most people thought that smiling faces were more honest than those in which there were no smiles. This difference was huge in some countries like Switzerland, Australia and the Philippines, but low in other countries like Pakistan, Russia and France. In some countries like Iran, India and Zimbabwe, smiles would not bring additional benefits in terms of trust.
Why? The answer is complicated, but to summarize, scientists have concluded that it is related to whether in a society, people generally badume that others are honest with them. " Higher levels of corruption reduce confidence in smiling individuals ", the authors of the research conclude
This attitude refers to an old vision of smiling as opposed to pious solemnity. When piety was a dominant value, smiles were frowned upon as a forerunner of laughter, which was treated with real disdain. Before the French Revolution, the broad smiles in art were mostly the kingdom of the lower clbades indecent, drunk and noisy.
Eastern religions, however, often use the smile for denoting enlightenment . Buddha and several religious figures have been portrayed with serene smiles, although the original Buddhist texts are as devoid of smiles as the Western scriptures. Jesus is crying, but never smiles.
— Illnesses that extinguish a smile —
Kevin does not smile either. Not at all. Four weeks after birth, he began receiving chemotherapy with vincristine, a drug so powerful that it can cause bone pain and rashes. The doctors warned his mother that the treatment could make him blind, deaf or in a wheelchair.
Whether it's the tumor or the drug, Kevin's number 17 cranial nerve, which leaves the medulla lengthened and travels across the face, he's faded. It is a nerve sensitive to tumors but also to rare diseases such as Moebius syndrome conbad facial paralysis caused by the absence or atrophy of cranial nerves. Those who suffer from it can not smile, frown or move their eyes from one side to the other.
"Basically, you have a mask on your face," says Roland Bienvenu, a 67-year-old Texan who
When we can not smile, others "may have a mistaken impression of you, "he says. "You can almost read their thoughts, they ask," What's wrong, did you have an accident? " Question your intellectual ability think that as one has this expression of emptiness, it may be due to an intellectual disability. "
There are other complications that can also prevent you from smiling.
different from the rest of the children, "says Silvia about her son Kevin." For four years he went through a feeding tube connected to his stomach, he could not lead a normal life because at every hour we had to connect him to the machine so that he could feed himself. "Remember that other children, curious, looked and asked what was wrong.
With time, Kevin was able to lead a more normal life, but he still felt the consequences of having a half-smile on a world established on "a cultural expectancy of pearly perfection ", as Richard Barnett says in his book "The Smile Thieves"
"I could not have smiled on the left, just right," Kevin says. "My smile was strange … people were asking me what had happened, why am I like that, I told them that I was born."
Facial paralysis is not obvious to others as to other disabilities, and it is quite rare that the majority of the population does not know the reasons that can cause it.
One of them is Bell's palsy an inflammation of the nerves that is on one side of the face. who are paralyzed and hang an eye and the corner of the mouth. Usually occurs in men and women between 15 and 60 years old.
In most cases, it is temporary and is wrapped in the same mystery that accompanies it.
Doctors suspect that it causes a viral infection, but there are also traumatic events, such as road accidents or sports, that can damage the nerves and muscles of the face, in addition to Conbad irregularities such as cleft palate
] A smile that hangs on one side is one of three signs that someone has had a stroke and needs immediate urgent care (the two others are numbness in one arm and difficulty speaking or incoherent speech). 19659003] Losing a smile is a big blow at any age, but it can have a special impact on young people, who are just starting to build relationships that will win them all their lives. "19659003" It's a big problem, "he says.Tami Konieczny, supervisor of Occupational Therapy at the Children's Hospital of Philadelphia," When you see someone, the first what you see is the face, your ability or your inability to smile or your asymmetrical smile, that's your social world. "
]" If someone can not read your facial expressions, he becomes difficult for them to accept you socially This is devastating for children, I have seen some of them retouch their photos on the computer. on the bright side and copying it, manipulate their own images before uploading them to social networks. "
Fixing an image on the screen is much easier than in real life, where you have to go through several plastic surgeries at different levels spread over a
" It is extremely important to be able to interact with humans face to face, "says Ronald Zuker, a Canadian plastic surgeon pioneering facial resuscitation." If you can not smile, you're at a disadvantage People can not not understand your internal emotions, they misinterpret your appearance as disinterestedness or lack of intelligence or lack of participation in the conversation. "
– – A long process —
Still, some parents prefer to wait until the children are older and can participate in the decision.
"If families want to wait, that's fine," said Zuker. "Sometimes, when a child is 9 or 10 years old, they look at each other in the mirror and say," You know, I really want this surgery. "It's time to do it."
That's what happened with Kevin. It was fine. " Even with a scar on his face, he was still popular at school," says his mother. "He was still a happy boy ."
But some comrades were making fun of him He said to his parents that he wanted to be able to do the same thing as everyone else, I knew that the process was going to be long, painful and difficult, but I wanted to do it.
In October 2015, Phuong Nguyen, a plastic surgeon from Children & # 39; s Hospital in Philadelphia, went to work removing some of the sural nerve from his right ankle. Kevin and grafted him on the right side of the face, pbading him under his left upper lip, paralyzed him.It let him grow for almost a year.Nerve fibers advance from about one millimeter a day
At that time, doctors periodically smelled Kevin's cheeks to see if the e nerve was fine. " When he tickles, you know that he is developing ," says Nguyen
Taking off some of the nerve in the ankle made Kevin feel that numb area, but as it was still growing, this area began to shrink When the Nervous Network took over
Once Nguyen was sure the grafted nerve was working, it was time to move on to the second stage of surgery.
One morning in August 2016, the doctor grabbed a purple marker and drew on Kevin's face what would be his smile. He pulled out 12 inches of muscle segment next to an artery and a vein section of Kevin's left thigh and held them in place with a separator tailor-made for Kevin's mouth.
Over the next year, Kevin started being able to move the left side of his mouth.
Kevin needed occupational therapy sessions to get where he is now. Do some exercises and put on purple latex gloves to pull inside your cheek. One of the exercises is to introduce an EMG (a rectangular black sensor that reads electrical activity into the muscle) on Kevin's left cheek so that he can play smiling and relaxing video games.
Physical rehabilitation is part of the surgical process it is usually examined over the shoulder, but it can determine success or failure.
"Especially in facial palsy," says Nguyen, who says that two patients who had the same treatment may show different results according to how they committed to his rehabilitation
Kevin smiles now "automatically", as he says: "Now he feels good, before it seems strange to him, he does not smile"
He remembers the moment when he noticed: "We were at the table by train to eat, and we said, "Kevin, are you moving that side?
— How did it change your life? —
" Before, I was very shy … Now I am becoming less active ," says Kevin.
"I had problems expressing my emotions … Now, when I play football and score a goal, I'm happy, I smile at everyone I've scored." [19659062]
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