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FORT WORTH The skull of nine-month-old Aden Aguirre is not growing correctly. Left untreated, it could sentence him to a life of ridicule and emotional pain and possibly damage his brain.

Aden's twin brother Andrew has the same problem only worse.

It's really scary for us, said Esmeralda Aguirre, the boys' grandmother. They're just babies.

Doctors at Cook Children's Medical Center in Fort Worth decided to operate on them immediately, back-to-back, starting with Andrew.

I've had kids come in who are 5, 6, 7 years old. It's extremely difficult to fix then, explained craniofacial surgeon Dr. Eric Hubli. The bones are much thicker and the face has adapted to an abnormal shape.

Dr. Hubli said the condition called craniosynostosis occurs only once in every 60,000 births, and he has never seen it repeated in twins.

Dr. Hubli and neurosurgeon Richard Roberts work as a team at Cook Childrens.

The brain sticks to inside of the skull, Dr. Hubli said. He's got to move it away so when I'm passing a saw underneath, he can protect.

Dr. Roberts removes large sections of skull; Dr. Hubli then reshapes them with a series of tiny cuts. It's a bit like cutting tortoise shell.

I want to reshape it without fracturing it too much, Dr. Hubli said.

The surgeons then replace the skull fragments and stitch them together like pieces of a puzzle. The extremely delicate procedure takes about four hours per child.

Following surgery, Andrew's head and face instantly look radically different.

Normal.

And that will make a world of difference for him.

Social acceptance, psychological development for the child it will affect education. It will affect every part of their lives, Dr. Hubli said.

The doctors said they made the unusual choice to operate on the twins the same day in order to spare the family a drawn-out drama.

The boys are too young to know or care about the skill and artistry of their surgical team, but someday they will.

E-mail jdouglas@wfaa.com

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