In the quiet aftermath of a caesarean birth in Singapore, a newborn girl named Sumayyah entered the world missing nearly 40 percent of her skin — a condition so rare and so severe that survival itself was considered unlikely. Over six months at Singapore General Hospital, a multidisciplinary team improvised, studied, and adapted, growing new skin from a fragment of her own body to shield organs visible to the naked eye. Her story, now five years on, is not simply one of medical triumph but of the long, layered work of helping a child belong to the world she was saved to inhabit.
Singapore doctors save girl born without 40% of her skin using cultured grafts
A newborn girl born with 40% of her skin missing faced life-threatening complications including potential brain herniation and infection, requiring six months of intensive hospitalization and ongoing medical care.
She will need to navigate reactions of others, but her care is as much about confidence as skin.
Mark
When you first saw her in the operating theatre, what was the immediate instinct—was it to save her, or to assess whether saving her was even possible?
Mimi
Both, I think. The moment you see 40 percent of a body without skin, your mind is already running through the catastrophes that could happen in the next hours. The brain herniation, the infection, the bleeding. But the fact that she was breathing, that she was alive—that changes the calculus. You don't have time to despair. You have to act.
Mark
The cultured skin took three weeks to grow. What were those three weeks like, knowing that every day without coverage was a day something could go wrong?
Mimi
Exhausting. You're changing dressings every two or three days, watching for the smallest sign of infection, managing fluids like you're defusing a bomb. The artificial matrix buys you time, but it's not skin. It's a placeholder. You're holding your breath the entire time.
Mark
Why did the team decide to culture skin rather than use a conventional graft?
Mimi
Because there was nowhere to take it from. She had almost no unaffected skin. Culturing was the only option that didn't require sacrificing what little protection she had. It meant waiting, but it was the only path forward.
Mark
Now, five years later, she's becoming self-conscious. Does the medical team feel responsible for that part of her life too?
Mimi
Absolutely. Keeping her alive was the first battle. But she's going to spend the rest of her life in a body that looks different. That's not a medical problem you can solve with surgery. It's something she has to learn to live with, and we have to help her do that—by supporting her confidence, by advocating for small accommodations like wearing a beanie to school, by making sure she knows her survival was worth fighting for.
Mark
What does it mean that her father shaves his head with her?
Mimi
It means he understands that her appearance is not a defect to hide or overcome. It's part of who she is. That kind of acceptance from family—that might matter more than any surgery.
Der Puls
- A newborn arrived with her brain, organs, and blood vessels visible through a translucent membrane — every hour without protective covering was a window for infection, hemorrhage, or herniation.
- With almost no healthy skin to harvest, the surgical team had no established playbook: one doctor read through 800 medical journals and found only fragments of guidance for a condition this extensive.
- Surgeons improvised a path forward — placing artificial biological scaffolds over her skull within days, then culturing a small groin sample into full skin grafts over three weeks, racing against the body's vulnerabilities.
- After six months of intensive hospitalization, Sumayyah was discharged — alive, but carrying grafted skin that cannot grow, stretch, or produce hair, requiring revision surgeries throughout her childhood.
- Now approaching primary school, the five-year-old faces a quieter but no less real challenge: her doctors are writing to schools and ministries, asking for small accommodations that might help her move through a world still learning to make room for difference.
In the quiet aftermath of a caesarean birth in Singapore, a newborn girl named Sumayyah entered the world missing nearly 40 percent of her skin — a condition so rare and so severe that survival itself was considered unlikely. Over six months at Singapore General Hospital, a multidisciplinary team improvised, studied, and adapted, growing new skin from a fragment of her own body to shield organs visible to the naked eye. Her story, now five years on, is not simply one of medical triumph but of the long, layered work of helping a child belong to the world she was saved to inhabit.
When Sumayyah was born by caesarean at Singapore General Hospital in 2020, her parents' first moments of relief quickly gave way to alarm. Nearly 40 percent of her body — her scalp, torso, and all four limbs — was covered not by skin but by a translucent membrane through which doctors could see her organs and blood vessels directly. The condition, aplasia cutis congenita, affects roughly one in 10,000 births, and at this scale, survival was far from certain.
The risks were immediate and compounding. Through gaps in the fragile membrane over her skull, her brain was visible and exposed. Tiny tears in the covering invited infection. A major blood vessel ran beneath the surface, and any rupture would be nearly uncontrollable. Brain herniation — the brain pressing outward through a weak point — was a constant threat. The caesarean delivery itself had likely spared her that fate; a vaginal birth might have caused herniation during labor.
With almost no healthy skin available to harvest for conventional grafts, the team had to build a solution from almost nothing. On day three, surgeons placed an artificial dermal matrix — a biological scaffold — over her scalp to protect her brain. On day ten, they extended the coverage to her torso and limbs, and simultaneously took a small skin sample from her groin to be cultured in a laboratory. For three weeks, the team changed her dressings every two to three days, managed fluid loss with precision, and administered antibiotics. Neonatologist Alvin Ngeow had worked through 800 medical journals on the condition, finding only scattered case reports. The team synthesized what little existed and improvised the rest — including a sterile saline bath fashioned from a drip stand and IV bag, with a heat lamp for warmth.
When the cultured skin arrived — a small groin sample expanded into several usable sheets — surgeons grafted it across her body. Six months after her birth, Sumayyah went home.
Now five years old, she is talkative and bright within the familiarity of home, but has grown quieter in public as she has become more aware of how she appears to others. The grafted skin is scar tissue: it cannot grow or stretch with her body, cannot produce hair, and will require revision surgeries throughout her childhood. Her father shaved his head in solidarity, though Sumayyah has since asked him to stop. As she prepares to enter primary school in 2027, her neonatologist has written to the Education Ministry and her school requesting that she be permitted to wear a beanie — a small gesture toward easing her passage into a world that does not always know how to receive difference. Her doctors expect her to lead a full life. The work of making that possible, it turns out, extends well beyond the operating theatre.
In 2020, when Siti Abdullah heard her newborn daughter cry after a caesarean delivery at Singapore General Hospital, the moment felt ordinary—until the room fell silent. Doctors and nurses began whispering urgently. Her husband, Abdul Rahman, was summoned into the operating theatre. When he first glimpsed his daughter, he thought she was simply covered in the residue of birth. Then he looked closer.
Sumayyah was born without skin covering nearly 40 percent of her body. Where skin should have been—across her scalp, torso, and all four limbs—there was only a translucent membrane, thin as plastic wrap. Through it, doctors could see her organs and blood vessels. The condition, aplasia cutis congenita, is extraordinarily rare, affecting roughly one in 10,000 births. Most infants born with such extensive missing skin do not survive.
The danger was immediate and multifaceted. A baby's skull consists of bones joined by flexible seams and soft spots called fontanelles, which allow the head to compress during birth and expand as the brain grows. Through these openings, doctors could see Sumayyah's brain directly beneath the transparent membrane. Worse, there were tiny tears in that fragile covering. Infection was a constant threat. Deep in the center of the brain runs the sagittal sinus, a major blood vessel; if it ruptured, bleeding would be nearly impossible to control. There was also the risk of brain herniation—the brain pushing outward through a weak point in the membrane. The caesarean delivery itself had likely saved her life; a vaginal birth might have caused her brain to herniate during labor.
Sumayyah was rushed to the neonatal intensive care unit and treated like a severe burn patient. The parallel was apt: both conditions involve massive loss of the skin's protective function. The team—a neonatologist, dermatologist, and plastic surgeon—had to work quickly. A standard split-skin graft, where doctors harvest the top layer of skin from an unaffected area to cover damaged regions, was impossible; Sumayyah had almost no spare skin to harvest. Instead, on day three of her life, surgeons placed an artificial dermal matrix—a specialized biological scaffold—over her scalp to shield her brain. On day ten, they extended this artificial covering to her torso and limbs. That same day, they took a small sample of skin from her groin and sent it to the laboratory to be cultured and grown.
For three weeks, the team maintained meticulous care, changing Sumayyah's dressings every two to three days, managing fluids with extreme precision to prevent dangerous losses through her exposed tissue, and administering antibiotics to ward off infection. The neonatologist, Alvin Ngeow, had read through 800 medical journals on the condition, though most offered only isolated case reports with incomplete guidance. The team had to synthesize what little knowledge existed. When the cultured skin arrived a month after birth—expanded from that tiny groin sample into several sheets—surgeons grafted it across her body. The dressing changes continued every two to three days for six months. Ngeow improvised a sterile saline bath using a drip stand and IV bag, keeping Sumayyah warm beneath a heat lamp, drawing on techniques he had learned during military service.
Sumayyah was discharged after six months. Now five years old, she carries the marks of her survival. The grafted skin is scar tissue, which does not grow or stretch like normal skin, so she will require ongoing scar revision surgeries and careful management through her childhood. The grafted areas cannot produce hair, leaving her bald. Her father began shaving his own head in solidarity, though Sumayyah has asked him to stop. She is an intelligent, talkative child at home, but as she has grown aware of her appearance, she has become quieter and more withdrawn in public. Her doctors recognize that the medical challenge—keeping her alive, protecting her organs, covering her body—was only the first part of her care. As she enters primary school in 2027, she will face the reactions of other children and strangers. Her neonatologist has written to the Education Ministry and her school requesting permission for her to wear a beanie, a small accommodation that may help her navigate a world not always prepared for difference. With consistent care and support, doctors expect her to lead a full, normal life.
Bemerkenswerte Zitate
To our knowledge, she is a living survivor with the largest extent of missing layers of skin in Singapore.— Alvin Ngeow, neonatologist at Singapore General Hospital
The doctors, nurses, and even the cleaners in the NICU assured and comforted us. They took care of Sumayyah like their own.— Siti Abdullah, Sumayyah's mother
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