A teen from Iceland suffers from facial paralysis. His parents heard about Riley plastic surgeon Dr. Gregory Borschel’s expertise in the condition and brought their son here.
By Maureen Gilmer, Riley Children’s Health senior writer, mgilmer1@iuhealth.org
Asgeir Solbergsson, 15, has flown 3,000 miles from Iceland to Indiana with his parents and stepfather to get his smile back.
That’s why he’s standing in an exam room at Riley Hospital for Children while Dr. Gregory Borschel explains the procedure the teen is about to undergo to restore function to his face.
The family has come all this way because they learned through doctors in Iceland about Dr. Borschel’s expertise in treating facial paralysis, also known as facial palsy.
The condition refers to weakness or paralysis of the facial muscles, often causing one side of the face to droop or to appear asymmetrical. It can affect the ability to smile, close the eye or control other facial expressions.
While the disorder can sometimes result from nerve damage or can occur at birth, there is no single event that Asgeir’s parents or doctors can point to that caused the condition in him.
It started appearing about four years ago, his parents said, gradually becoming more noticeable over the next few years.
“We first noticed a small crook in his smile,” Hafrún Guðmundsdóttir said about her son, sharing pictures of him from 2021. “It started very slowly.”
The parents exhausted themselves chasing answers, at one point saying their son was the “most tested human in Iceland.”
It was about a year ago when a plastic surgeon in Iceland reached out to Dr. Borschel, chief of plastic surgery for Riley Children’s Health, on behalf of the teen’s pediatrician.
The family corresponded with the renowned Riley plastic surgeon over several months, and last month, they made the trip across the Atlantic to Indianapolis to meet the Riley team in person the day before the teen’s first surgery.
“They said he was the best,” Solberg Asgeirsson, Asgeir’s dad, said of Dr. Borschel.
Riley President David Biggerstaff was among those on hand to greet the family and welcome them to Indiana and, more specifically, to Riley.
“We are honored that you chose Riley Hospital in Indiana, and we are honored to have the type of specialty care that Dr. Borschel provides,” Biggerstaff said. “The expertise we offer makes Riley a special place. Thank you for trusting us.”
Dr. Borschel took the opportunity during the meeting to explain what he would be doing in the operating room the next morning, a procedure expected to take five to six hours.
“We’ll tap into the strong side here,” he said, pointing to the young man’s face, “make an incision over here and look for the nerves that are working. We can tap into the extra, take a nerve graft from his left side and tunnel it across to the weak side, then leave the ends of the nerves over here.”
And then they wait.
For a year.
If all goes to plan, Asgeir will return next year for the second part of the procedure, where Dr. Borschel will remove a muscle from the teen’s thigh and connect it to the nerve that is placed in the face.
“Stage 1 is the nerves, stage 2 is the muscles,” the surgeon said. “It’s only when we add new muscle that he will gain more movement (smiling and eyelid closure). And it’s a slow process.”
In fact, the hardest part of the whole process is the waiting, he said, as nerves regenerate very slowly.
“We have to wait for all these nerves to grow through the graft and get to the other side.”
Once the second part of the procedure is done, it will take another four months or so for Asgeir’s smile to straighten.
A few days after the surgery, Dr. Borschel said everything went well, and Asgeir and his family returned to Iceland a week ago.
Reached via email, Asgeir’s mom said her son is feeling pretty good, happy to have that surgery out of the way.
“We are so grateful to everybody at Riley, all the people who made everything as easy for us as possible and really showed us care,” she said.
Biggerstaff told the family he looks forward to seeing them again in a year. “We want to make sure you have a great experience.”
In the meantime, Dr. Borschel will continue to consult with Asgeir and his parents over Zoom to ensure that his healing continues as expected.
Photos submitted and by Mike Dickbernd, IU Health visual journalist, mdickbernd@iuhealth.org
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