Valeka Riegel from Oak Harbor, Ohio, gave birth to Zakary on December 29, 2016. For the first four months of his life, Zakary had a large sac covering his face, obscuring his eyes and nose and leaving only a small part of his mouth visible. Riegel shared her experience in a letter to her son for Cincinnati Children’s Hospital, describing the sac as so heavy it began to crush Zakary’s nasal cavities, prompting doctors to create a sling to lift the sac off his mouth and nose.

“I cried, became angered, fearful and resentful of God,” Riegel, 46, wrote. “I could not see your face, only a large protrusion and tiny little lips — no eyes, no nose, no eyelashes. Yet, you were still beautiful to me.”

During Riegel’s fifth month of pregnancy, doctors diagnosed Zakary with encephalocele, a rare birth defect where brain tissue escapes the skull and collects in a sac between the eyes. Zakary was delivered via Caesarean section by a team of 22 doctors.

Initially, Zakary was too small to undergo the required nine-hour surgery to remove the growth. In April 2017, however, doctors successfully removed the sac, repaired the gap in his skull, and reconstructed his face. Riegel recalled her emotions after the surgery, “I just cried because I didn’t know he had such beautiful long eyelashes and big brown eyes. They were perfect on both sides.”

Reflecting on the past year, Riegel expressed disbelief and joy at Zakary’s progress, “I never in a million years thought we would be here a year later.” She marveled at seeing her son’s face for the first time in its entirety.

However, the change required some adjustment. Riegel had grown to love Zakary with the sac, and Zakary himself was used to it, often playing with it. After the surgery, he initially seemed confused, swatting at his face where the sac used to be. Despite these adjustments, Riegel was profoundly grateful and amazed by the transformation, describing her son’s new appearance as “amazing.”