Twin brothers who were born conjoined, sharing part of their sternum, diaphragm, abdominal wall and liver, recently celebrated their first birthday after undergoing successful separation surgery.
Amari and Javar Ruffin celebrated their first birthday on Sept. 29, just one month after undergoing an eight-hour surgery at Children's Hospital of Philadelphia to separate their bodies and rebuild each of their abdomens.
The brothers' first birthday was a milestone their parents Tim and Shaneka Ruffin said they were not sure they would see with their sons, the youngest of their four children.
When a routine ultrasound 12 weeks into her pregnancy showed that her sons were conjoined, Shaneka Ruffin said it was recommended to her that she terminate her pregnancy.
"We were home when we actually got the phone call from the specialist telling us all the details about the twins," Shaneka Ruffin told "Good Morning America." "When she said that it was best that we terminate, it was a lot of emotions, because that was the first thing that was said."
The Ruffins, who live in Philadelphia, said they decided to get a second opinion at Children's Hospital of Philadelphia, where they were told that though their twin sons had a rare condition, they could be separated successfully.
Conjoined twins occur roughly once in every 35,000 to 80,000 births, according to Children's Hospital of Philadelphia, which has performed over 30 conjoined twin separations since the 1950s.
Amari and Javar were omphalopagus twins, meaning they faced one another and were joined at the anterior abdominal wall from the xiphoid to the umbilicus, according to the hospital.
When they were born via cesarean section on Sept. 29, 2023, the brothers weighed a combined 6 pounds.
Amari and Javar spent the first 10 months of their lives hospitalized at Children's Hospital of Philadelphia, where doctors and nurses prepared diligently for their separation surgery.
Dr. Holly L. Hedrick, a pediatric general and fetal surgeon at the hospital, said doctors were hopeful for a successful surgery, in part, because Amari and Javar did not share a heart.
"These hearts being separated and being separate from each other, and being completely functionally and anatomically and structurally normal was a huge win," Hedrick told "GMA," adding that even with detailed scans, there is no certainty until the surgery begins. "I'd say 90% of conjoined twins that are diagnosed in the world don't make it to this point that the boys have made it to."
She continued, "It's very nerve-racking in the beginning just to try to nail the diagnosis, just to try to be sure that we completely understand the anatomy, because a lot of times, it's an impossible feat."
On the day of the surgery, Aug. 21, 2024, a surgical team of more than two dozen specialists, including surgeons, anesthesiologists, radiologists, nurses and many others, operated for eight hours, according to Children's Hospital of Philadelphia. The brothers' abdomens were then rebuilt using layers of mesh and plastic surgery techniques.
After spending nearly their first year of life conjoined, Amari and Javar are now establishing their independence, including sitting up, rolling, and starting to scoot and crawl, according to their parents.
"Javar is spicy. Amari is more laid-back," said Shaneka Ruffin. "They're doing a lot of things at age 1 that they wouldn't have been able to do if they were connected."
"The whole situation was a crazy journey, but to be here right now is still surreal to this day," added Tim Ruffin. "It's beautiful."
Both Amari and Javar went home on Oct. 8, a milestone celebrated by their parents and 9-year-old and 4-year-old siblings.
The twins are continuing to receiving therapies including speech therapy and physical therapy.
The Ruffins said that after a nearly two-year journey from diagnosis to separation, they've learned to always seek a second opinion and to advocate for their sons.
"Don't give up," Tim Ruffin said. "This is a hard journey but don't give up."
